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Kıncal İ, Irklı FA. Vocal Fatigue and Its Relationship with Vocal Hygiene and Work-Related Factors in Professional and Nonprofessional Voice Users: A Multiple Linear Regression Model Study. J Voice 2024:S0892-1997(24)00152-8. [PMID: 38796395 DOI: 10.1016/j.jvoice.2024.05.001] [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: 04/04/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVES To investigate vocal fatigue severity between professional voice users (PVUs) and nonprofessional voice users (NPVUs), and across different levels of voice users. Also to examine the relationship between vocal hygiene and work-related factors with vocal fatigue. METHODS This is a cross-sectional descriptive study. Four hundred one individuals from different professions were included in total. Participants were divided into four levels of voice users by classification of Koufman and Isaacson. The top three levels of voice users further identified as PVU, and level 4 voice users identified as NPVU. An online questionnaire which included vocal hygiene checklist, work-related factors, and Turkish version of vocal fatigue index (VFI) was submitted by the participants. RESULTS Vocal fatigue severity of PVUs were found higher than NPVUs in all VFI scores (P < 0.05). Level 2 voice users were found to have more vocal fatigue severity than all other levels of voice users. Call center workers (CCWs) had the highest means of vocal fatigue severity. Based on the multiple linear regression model vocal hygiene and the number of vocal rest breaks were found to have related with vocal fatigue the most (P < 0.05). There was also a relation with some VFI scores (P < 0.05) with voice usage duration at work and vocal rest duration. We found no relationship between working experience and vocal fatigue. The data suggests the relation between vocal fatigue and vocal hygiene, and work-related factors explain a small proportion of the association. However, in CCWs r2 was found 0.44. CONCLUSIONS The change in vocal fatigue severity did not match with Koufman and Isaacson's classification of voice users. We suggest that there may be other contributing factors to vocal fatigue than vocal hygiene, vocal rest, and voice usage duration even those factors may differ from profession to profession.
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Affiliation(s)
- İlayda Kıncal
- Anadolu University Graduate School, Department of Speech and Language Therapy, Eskişehir, Turkiye.
| | - Furkan Ali Irklı
- Anadolu University Graduate School, Department of Speech and Language Therapy, Eskişehir, Turkiye
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Wollenburg M, Wolowski A. Impact of professional, recreational and nonsinging on temporomandibular disorders - a comparative study based on a self-assessment questionnaire. Head Face Med 2024; 20:19. [PMID: 38515168 PMCID: PMC10956313 DOI: 10.1186/s13005-024-00419-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/18/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND This study investigates the relationship between professional and recreational singing on temporomandibular disorders (TMDs) in women compared to a nonsinging control group. METHODS A total of 288 female subjects between the ages of 18 and 45 participated in the self-assessment questionnaire including demographic data, as well as questions on vocal practice and TMDs symptoms. Depending on the singing time per week, the (non)vocalists were assigned to the groups professional (n = 96), recreational (n = 96) and nonsingers (n = 96). RESULTS The TMDs prevalence in professional singers (42%) was higher than that in recreational singers (31%) and noticeably higher than that in nonsingers (25%). The Fisher-Freeman-Halton exact test showed that the differences between the groups were not noticeable (p = .053) but could be formulated as tendencies. The professionals suffered much more from restricted jaw movement (p = .004; OR = 2.718; 95% CI = 1.409-5.242), temporomandibular joint sounds (p < .009; OR = 2.267; 95% CI = 1.264-4.064) and temporomandibular pain (p = .010; OR = 2.333; 95% CI = 1.264-4.308) than nonsingers. CONCLUSIONS Singing might have an enhancing effect on the appearance of TMDs. In particular, professional singers suffered more from self-reported TMDs than recreational singers and nonsingers. In addition to the high level of physical workload if participating in professional singing, the psychosocial impact should be investigated more in further studies. No new treatment strategies resulted from this study, as the etiological significance of singing is still unclear. Knowledge about risk factors for multifactorial TMDs can help practitioners and patients prevent and treat TMDs.
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Affiliation(s)
- Maja Wollenburg
- Department of Prosthodontics, University Hospital Münster, Albert-Schweitzer-Campus 1/W30, Münster, 48149, Germany.
| | - Anne Wolowski
- Department of Prosthodontics, University Hospital Münster, Albert-Schweitzer-Campus 1/W30, Münster, 48149, Germany
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Nair RM, Joshi A, Gunjawate DR. Knowledge, Attitude and Practices Towards Vocal Health Care Amongst Indian Carnatic Singers. J Voice 2024; 38:161-169. [PMID: 34364742 DOI: 10.1016/j.jvoice.2021.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The knowledge, attitudes and practices of Indian Carnatic singers is a dimension that yet to be explored in detail. The aim of the current study was to explore these knowledge, attitudes, and practices amongst Indian Carnatic singers towards vocal health care. STUDY DESIGN Cross-sectional online questionnaire-based study. METHOD A cross-sectional online questionnaire-based study design was used to explore the knowledge, attitudes, and practices of Indian Carnatic singers towards vocal health care. The study was conducted in two phases, phase I involved questionnaire development and validation while phase II involved collection of data and further analysis. RESULTS One hundred trained self-identified Indian Carnatic singers participated in this study. These singers displayed good knowledge and positive attitudes towards vocal health care. A preference (73%) towards home remedies was noted as compared to seeking medical attention. The measures reported by the singers for maintaining good vocal health revealed use of several home remedies, vocal as well as non-vocal measures. CONCLUSION The findings of the present study reveal the knowledge and attitude of Indian Carnatic singers towards vocal health care as well as highlight several interesting practices.
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Affiliation(s)
- Raveena M Nair
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ashwini Joshi
- Department of Communication Sciences and Disorders, University of Houston, Texas, United States of America
| | - Dhanshree R Gunjawate
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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Sari E, Nteli Chatzioglou G, Temirbekov D, Aliyeva A, Gurses İA. Angles of Needle Insertion for True Vocal Fold Access Via the Thyrohyoid and Cricothyroid Membranes of the Larynx. J Voice 2023:S0892-1997(23)00324-7. [PMID: 38007364 DOI: 10.1016/j.jvoice.2023.10.014] [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: 07/25/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVE This study aims to provide an analysis of the cricothyroid and thyrohyoid membrane approaches for laryngeal injections in cadaveric vocal cords. The primary objective is to determine the optimal techniques, needle trajectories, and anatomical landmarks for accessing different regions of the vocal cords percutaneously. MATERIALS AND METHODS The study was conducted on 23 adult cadavers, consisting of 8 females and 15 males. The cadaveric larynges were mounted vertically to ensure proper anatomical positioning. Both the cricothyroid and thyrohyoid membrane approaches were utilized for reaching the vocal cords. Measurements were taken for needle trajectories, angles, and distances to determine the optimal approach for accessing the anterior, middle, and posterior thirds of the vocal cord. RESULTS Through the thyrohyoid membrane approach, the anterior, middle, and posterior thirds of the vocal cords can be accessed with the optimal needle insertion coronal angles of 15.46 ± 7.86°, 16.52 ± 7.15° and 18.29 ± 14.46°, and sagittal angles of 126.01 ± 9.65°, 116.67 ± 8.04° and 111.02 ± 8.86° respectively at a lateral distance of 1.92 ± 1.62 mm from the midline and 8.48 ± 2.73 mm below the vertical line. From the cricothyroid membrane approach, optimal coronal and sagittal insertion angles of the anterior, middle, and posterior thirds of the vocal cord were respectively: 158.95 ± 9.3°, 156.09 ± 11.59°, 152.4 ± 14.46°, 11.5 ± 7.77°, 21.83 ± 12.47° and 32.91 ± 12.59°. CONCLUSION This analysis of the cricothyroid and thyrohyoid membrane approaches in cadaveric larynges provides valuable insights for clinicians and researchers in the field of laryngology. The findings serve as a reference for optimizing laryngeal injection techniques, enhancing patient outcomes, and minimizing complications.
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Affiliation(s)
- Elif Sari
- Istanbul Aydin University, Faculty of Medicine, Department of Otorhinolaryngology Istanbul, Türkiye
| | - Gkionoul Nteli Chatzioglou
- Istanbul Health and Technology University, Faculty of Medicine, Department of Anatomy, Istanbul, Türkiye; Istanbul University, Faculty of Medicine, Department of Anatomy, Istanbul, Türkiye
| | - Dastan Temirbekov
- Istanbul Aydin University, Faculty of Medicine, Department of Otorhinolaryngology Istanbul, Türkiye.
| | - Aynur Aliyeva
- The Cincinnati Children's Hospital Medical Center, The Division of the Otolaryngology, Ohio
| | - İlke A Gurses
- Koc University, Faculty of Medicine, Department of Anatomy, Istanbul, Türkiye
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Raheja S, Kelkar P. Modes of Educating Teachers About Vocal Hygiene: A Comparative Study. J Voice 2023:S0892-1997(23)00309-0. [PMID: 37925329 DOI: 10.1016/j.jvoice.2023.09.031] [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: 08/09/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVES Educating teachers about vocal hygiene can be a means of alleviation or prevention of voice problems in this population. The present study aimed to compare four modes of educating teachers in India (n = 80) about vocal hygiene. METHOD Four groups of 20 teachers were exposed to educative material on the vocal hygiene program created for the present study. Each group received it either in audio mode delivered by the researcher posing as a voice therapist (VA); in audio mode delivered by a researcher posing as a teacher (TA); in written mode delivered by the researcher posing as a voice therapist (VW); or in written mode delivered by a researcher posing as a teacher (TW). The improvement in the knowledge of teachers before and after vocal hygiene education was gauged by administering a written questionnaire before and after the content that the teachers received. RESULTS Results revealed that all four modes were effective in vocal hygiene education. However, no significant difference (P > 0.05) in the improvement of knowledge in teachers across the four modes was seen although the relative mean difference was observed higher for TW mode than other modes. Individual item analyses revealed that some concepts were conveyed more effectively than others. This gave insights into improving the quality and efficacy of vocal hygiene programs in the future. CONCLUSION Findings have implications in reaching out to remote areas and employing peer-to-peer teaching as an effective way of vocal hygiene education among teachers.
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Affiliation(s)
- Surbhi Raheja
- School of Audiology and Speech Language Pathology, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
| | - Pallavi Kelkar
- School of Audiology and Speech Language Pathology, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India.
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Robotti C, Schindler A, Lechien JR, Di Sabatino A, Capobianco S, Schindler A, Ottaviani F, Sims HS, Bertino G, Benazzo M, Mozzanica F. Prevalence of Laryngopharyngeal Reflux Symptoms, Dysphonia, and Vocal Tract Discomfort in Amateur Choir Singers. J Voice 2023; 37:932-944. [PMID: 34404581 DOI: 10.1016/j.jvoice.2021.06.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/15/2021] [Accepted: 06/20/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Vocal tract discomfort (VTD), dysphonia, and laryngopharyngeal reflux (LPR) symptoms are complaints frequently reported by amateur singers. There are two aims of this study. The first is to evaluate the prevalence of these symptoms using validated questionnaires. The second is to correlate singing-related variables with the questionnaire responses. METHODS A total of 392 amateur choir singers (ACS) and 514 control subjects completed an online survey divided into four parts: (1) clinical and demographic characteristics, (2) training in singing and singing experience, (3) history of gastroesophageal reflux disease and LPR symptoms, (4) validated questionnaires. Specifically, the reflux symptom index (RSI), the vocal tract discomfort scale (VTDS), and the voice symptom scale (VoiSS) were included to analyze the actual burden related to LPR symptoms, VTD, and dysphonia. RESULTS ACS demonstrated a healthier lifestyle and a lower prevalence of gastroesophageal reflux disease symptoms in comparison with control subjects. ACS scored significantly higher in VTDS and VoiSS than control subjects, while no differences in the RSI results were found. Significant correlations among the questionnaires' results were demonstrated. Occasional professional singing was the variable influencing VTDS and VoiSS results the most. CONCLUSION ACS do not evidently manifest a higher impairment connected to LPR (RSI score), while they do report higher levels of voice (VoiSS score) and vocal tract (VTDS score) impairments, in comparison with control subjects. The relevant correlations among the PRO measures suggest that LPR symptoms, VTD, and dysphonia are related to each other. Given the relevant repercussion on the severity of VTD and dysphonia, providers should specifically ask about occasional professional singing when treating amateur singers.
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Affiliation(s)
- Carlo Robotti
- Department of Otolaryngology - Head and Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Antonio Schindler
- Department of Biochemical and Clinical Science "L. Sacco", Luigi Sacco University Hospital, University of Milan, Milan, Italy
| | - Jerome R Lechien
- Department of Otolaryngology - Head and Neck Surgery, Foch Hospital, Paris Saclay University, Paris, France
| | - Antonio Di Sabatino
- Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Silvia Capobianco
- Department of Surgical Pathology, Medical, Molecular and Critical Area, ENT section, Pisa, Italy
| | - Antonio Schindler
- Department of Biochemical and Clinical Science "L. Sacco", Luigi Sacco University Hospital, University of Milan, Milan, Italy
| | - Francesco Ottaviani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Department of Otorhinolaryngology, IRCCS Multimedica, Milan, Italy
| | - H Steven Sims
- Chicago Institute for Voice Care, Department of Otolaryngology, University of Illinois Medical Center, Chicago, Illinois
| | - Giulia Bertino
- Department of Otolaryngology - Head and Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Marco Benazzo
- Department of Otolaryngology - Head and Neck Surgery, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Francesco Mozzanica
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Department of Otorhinolaryngology, IRCCS Multimedica, Milan, Italy.
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Hamdan AL, Hosri J, Feghali PAR, Abi Zeid Daou C, Ghanem A. Office-based Blue Laser Therapy of Vocal Fold Polyps: A Cohort of 18 Patients: Blue Laser Therapy of Vocal Fold Polyps. Laryngoscope 2023; 133:2712-2718. [PMID: 36752582 DOI: 10.1002/lary.30602] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/21/2022] [Accepted: 01/22/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To investigate the effect of office-based blue laser therapy of vocal fold polyps on voice. METHODS The medical records and video recordings of patients who underwent office-based laser therapy in a tertiary referral center between February 2020 and May 2020, and May 2021 and October 2022 was conducted. Only patients with vocal fold polyps who had undergone office-based blue laser therapy were included. The voice was evaluated before and after surgery using the Voice Handicap Index-10 (VHI-10), GRB perceptual evaluation, acoustic analysis, and maximum phonation time. RESULTS A total of 18 patients were included. The mean age of the study group was 52.5 ± 11.94 years. The male-to-female ratio was 2:1. Ten patients of the total group (53.6%) had hemorrhagic polyps and the most common site was the mid-third of the vocal fold. All patients who presented for follow-up (n = 15) had partial or complete regression of the lesion (4 and 11, respectively). There was a significant decrease in the mean score of VHI-10 (17.6 ± 9.97 vs. 4.27 ± 5.76, p < 0.001) and in the means of grade of dysphonia (2.0 ± 0.73 to 0.5 ± 0.63, p < 0.001), roughness (1.88 ± 0.81 to 0.44 ± 0.51, p < 0.001) and breathiness (0.81 ± 0.75 to 0.13 ± 0.34 p < 0.001). There was also a marked decrease in the perturbation parameters (jitter and shimmer) and a significant increase in the MPT from 10.66 ± 4.22 s to 14.26 ± 6.26 s (p = 0.028). CONCLUSION Office-based blue laser therapy is an effective treatment modality in patients with vocal fold polyps. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2712-2718, 2023.
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Affiliation(s)
- Abdul-Latif Hamdan
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Jad Hosri
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Patrick Abou Raji Feghali
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Christophe Abi Zeid Daou
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Anthony Ghanem
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
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Azadeh Ranjbar P, Maxwell PJ, Barna A, Balouch B, Hawkshaw M, Al Omari AI, Lyons K, Alnouri G, Sataloff RT. An Exploration of the Risk Factors, Severity, and Sequelae of Vocal Fold Hemorrhage in a Population of Voice Patients Before and After Diagnosis. J Voice 2023:S0892-1997(23)00181-9. [PMID: 37550112 DOI: 10.1016/j.jvoice.2023.06.009] [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: 04/13/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Vocal fold hemorrhage (VFH) is the rupture (usually acute) of a blood vessel within the true vocal fold. The long-term sequelae of VFH on the mucosal wave (MW) and glottic gap on video stroboscopy remain understudied. The primary objective of this study was to investigate the short-term and long-term consequences of VFH through measured and rated analysis of the mucosal wave and glottic gap. METHODS The presence of VFH and its extent (limited/moderate vs. extensive VFH) were identified. The primary outcome of this study was mucosal wave, which was assessed on an ordinal scale by three blinded raters pre and posthemorrhage. Only patients who had undergone strobovideolaryngoscopy before sustaining VFH were included. Mucosal wave and glottic gap also were measured using image pixel analysis using the open-access tool, ImageJ (NIH, Bethesda, MD). RESULTS Twenty-three subjects were included in this study (mean age 39.78 ± 15.54). Intra-rater reliability for MW ratings was 81.48% ± 6.150% (minimum 77.78%) for all evaluators (κ = 0.519 [0.267-0.772], P < 0.001). Inter-rater reliability analysis revealed 75.56% agreement between evaluators (κ = 0.524 [0.425-0.623], P < 0.001). MWMeasured extrapolated from ImageJ methodology correlated significantly with MWRated (n = 70, r = 0.448, P < 0.001). ΔMWMeasured from baseline to follow-up evaluation were compared for both the initial follow-up visit (FU1) and the second follow-up visit (FU2) [-4.135 ± 31.01 vs. 36.50 ± 39.97, P = 0.025]. Hence, ΔMWMeasured was significantly better by FU2 than FU1, with the larger positive change from baseline representing a greater improvement in the measured mucosal wave. Additionally, there were significant differences in ΔMWRated between those with limited/moderate VFH and those with extensive VFH at FU1. Duration of absolute voice rest correlated significantly with time to VFH resolution. Long-term change in mucosal wave after hemorrhage was assessed using both ΔMWMeasured and MWRated. Based on ΔMWRater, 35.0% of subjects demonstrated ongoing and worse mucosal wave restriction compared to baseline at their most recent follow-up visit. Based on ΔMWMeasured, 50.0% of the subjects showed ongoing and worse mucosal wave restriction compared to baseline at their most recent follow-up visit. CONCLUSION Overall long-term restrictions in MW after hemorrhage were present in 35.0% of the subjects based on ratings and 50.0% of the patients based on the measured MW using ImageJ, demonstrating the importance of ongoing study into this pathology and how to prevent it, especially in PVU and professional singers. Patients presenting with extensive hemorrhage were at risk for more prominent, detectable changes in mucosal wave compared to those with limited/moderate hemorrhage in the short-term, defined by a mean FU time of 3 months, but not long-term, characterized by a mean FU time 6 months or greater. Whether the severity of VFH is a true indicator of mucosal wave alterations requires additional study, as does the reliability and validity of ImageJ mucosal wave and glottic gap measurement techniques.
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Affiliation(s)
| | | | - Alexander Barna
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Bailey Balouch
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Mary Hawkshaw
- Department of Otolaryngology, Drexel University College of Medicine, Philadelphia, PA, USA
| | | | - Karen Lyons
- Department of Otolaryngology, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Ghiath Alnouri
- Department of Otolaryngology, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Robert T Sataloff
- Department of Otolaryngology, Drexel University College of Medicine, Philadelphia, PA, USA; Lankenau Institute for Medical Research, Wynnewood, PA, USA.
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Biehl A, Colmon R, Timofeeva A, Gracioso Martins AM, Dion GR, Peters K, Freytes DO. Scalable and High-Throughput In Vitro Vibratory Platform for Vocal Fold Tissue Engineering Applications. Bioengineering (Basel) 2023; 10:602. [PMID: 37237672 PMCID: PMC10215097 DOI: 10.3390/bioengineering10050602] [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: 04/06/2023] [Revised: 05/05/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
The vocal folds (VFs) are constantly exposed to mechanical stimulation leading to changes in biomechanical properties, structure, and composition. The development of long-term strategies for VF treatment depends on the characterization of related cells, biomaterials, or engineered tissues in a controlled mechanical environment. Our aim was to design, develop, and characterize a scalable and high-throughput platform that mimics the mechanical microenvironment of the VFs in vitro. The platform consists of a 24-well plate fitted with a flexible membrane atop a waveguide equipped with piezoelectric speakers which allows for cells to be exposed to various phonatory stimuli. The displacements of the flexible membrane were characterized via Laser Doppler Vibrometry (LDV). Human VF fibroblasts and mesenchymal stem cells were seeded, exposed to various vibratory regimes, and the expression of pro-fibrotic and pro-inflammatory genes was analyzed. Compared to current bioreactor designs, the platform developed in this study can incorporate commercial assay formats ranging from 6- to 96-well plates which represents a significant improvement in scalability. This platform is modular and allows for tunable frequency regimes.
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Affiliation(s)
- Andreea Biehl
- Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina-Chapel Hill, 4130 Engineering Building III, Campus Box 7115, Raleigh, NC 27695, USA (R.C.); (A.M.G.M.)
- Comparative Medicine Institute, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27606, USA
| | - Ramair Colmon
- Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina-Chapel Hill, 4130 Engineering Building III, Campus Box 7115, Raleigh, NC 27695, USA (R.C.); (A.M.G.M.)
- Comparative Medicine Institute, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27606, USA
| | - Anastasia Timofeeva
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA; (A.T.); (K.P.)
| | - Ana Maria Gracioso Martins
- Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina-Chapel Hill, 4130 Engineering Building III, Campus Box 7115, Raleigh, NC 27695, USA (R.C.); (A.M.G.M.)
- Comparative Medicine Institute, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27606, USA
| | - Gregory R. Dion
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, OH 45267, USA;
| | - Kara Peters
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA; (A.T.); (K.P.)
| | - Donald O. Freytes
- Joint Department of Biomedical Engineering, North Carolina State University & University of North Carolina-Chapel Hill, 4130 Engineering Building III, Campus Box 7115, Raleigh, NC 27695, USA (R.C.); (A.M.G.M.)
- Comparative Medicine Institute, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27606, USA
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Elsaeed A, Afsah O, Nawka T, Caffier P, Baz H. Treatment of Vocal Fold Nodules: Transnasal Steroid Injection Versus Microlaryngoscopic Phonomicrosurgery. J Voice 2023:S0892-1997(23)00038-3. [PMID: 36882331 DOI: 10.1016/j.jvoice.2023.02.003] [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: 12/09/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVES Vocal fold nodules (VFNs) are bilateral, mid-membranous, swellings of the vocal folds. Intralesional steroid injection was successfully tried in the management of benign vocal fold lesions including nodules. The aim of the present study was to compare treatment outcomes of vocal fold steroid injection (VFSI) and surgery in patients with VFNs in terms of lesion regression, subjective, and objective voice parameters. STUDY DESIGN Nonrandomized controlled clinical trial. METHODS This bicenter interventional study was conducted on 32 patients with VFNs, in the age range of 16-63 years. Sixteen patients underwent transnasal VFSI under local anesthesia (the injection group), and 16 underwent surgical excision of the nodules under general anesthesia (the surgery group). Prior to intervention and at the follow-up visit, participants were subjected to videolaryngoscopic examination with evaluation of nodules' sizes as well as subjective voice assessment by auditory perceptual assessment (APA) of voice and the international nine-item Voice Handicap Index (VHI-9i). Objective voice assessments including the measurements of cepstral peak prominence, jitter, shimmer, harmonic to noise ratio, and maximum phonation time were also administered. RESULTS The size of vocal fold nodules was significantly decreased postintervention in both studied groups. There was a decrease in the VHI-9i score, a decrease in the values of jitter and shimmer, together with an increase in the values of cepstral peak prominence and maximum phonation time after interventions indicating improvement of subjective and objective voice outcomes in both groups. CONCLUSION Office-based transnasal VFSI is a safe and tolerable therapy option for VFNs. Voice outcomes of VFSI were comparable to surgery, hereby VFSI can be considered a promising therapy for VFNs and could be used as an alternative to surgery in selected cases.
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Affiliation(s)
- Asser Elsaeed
- Phoniatric Unit, ORL Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Omayma Afsah
- Phoniatric Unit, ORL Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Tadeus Nawka
- Department of Audiology and Phoniatrics, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Philipp Caffier
- Department of Audiology and Phoniatrics, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Hemmat Baz
- Phoniatric Unit, ORL Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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11
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Novaleski CK, Doty RL, Nolden AA, Wise PM, Mainland JD, Dalton PH. Examining the Influence of Chemosensation on Laryngeal Health and Disorders. J Voice 2023; 37:234-244. [PMID: 33455853 PMCID: PMC8277875 DOI: 10.1016/j.jvoice.2020.12.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 12/19/2020] [Accepted: 12/21/2020] [Indexed: 02/06/2023]
Abstract
Inhaled airborne stimuli are associated with laryngeal disorders affecting respiration. Clinically, several themes emerged from the literature that point to specific gaps in the understanding and management of these disorders. There is wide variation in the types of airborne stimuli that trigger symptoms, lack of standardization in provocation challenge testing using airborne stimuli, and vague reporting of laryngeal symptoms. Scientifically, evidence exists outside the field of voice science that could prove useful to implement among patients with impaired laryngeal-respiration. To expand this area of expertise, here we provide a thematic overview of relevant evidence and methodological tools from the discipline of chemosensory sciences. This review provides distinctions across the three chemosensory systems of olfaction, trigeminal chemesthesis, and gustation, guidance on selecting and delivering common chemosensory stimuli for clinical testing, and methods of quantifying sensory experiences using principles of human psychophysics. Investigating the science of chemosensation reveals that laryngeal responses to inhaled airborne stimuli have explanations involving physiological mechanisms as well as higher cognitive processing. Fortunately, these findings are consistent with current pharmacological and nonpharmacological interventions for impaired laryngeal-respiration. Based on the close relationships among inhaled airborne stimuli, respiration, and laryngeal function, we propose that new perspectives from chemosensory sciences offer opportunities to improve patient care and target areas of future research.
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Affiliation(s)
- Carolyn K Novaleski
- Monell Chemical Senses Center, Philadelphia, Pennsylvania; Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan; Department of Neurology, Mayo Clinic, Rochester, Minnesota.
| | - Richard L Doty
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Alissa A Nolden
- Department of Food Science, University of Massachusetts-Amherst, Amherst, Massachusetts
| | - Paul M Wise
- Monell Chemical Senses Center, Philadelphia, Pennsylvania
| | - Joel D Mainland
- Monell Chemical Senses Center, Philadelphia, Pennsylvania; Department of Neuroscience, University of Pennsylvania, Philadelphia, Pennsylvania
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12
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Vermeulen R, du Toit M, van Lierde K, Graham MA, van der Linde J. Self-reported Vocal Demands, Perceptions, and Knowledge of Occupational Voice Users in South Africa. J Voice 2023:S0892-1997(23)00032-2. [PMID: 36849300 DOI: 10.1016/j.jvoice.2023.01.032] [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: 12/02/2022] [Revised: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVES The study aimed to describe daily vocal demands, perceptions and knowledge as reported by occupational voice users. STUDY DESIGN A descriptive, cross-sectional research design was employed. METHODS A survey on vocal demands, perceptions and knowledge was distributed to 102 occupational voice users via a snowball sampling technique. RESULTS Slightly more than half of the participants (55%) reported using their voice for work 36.5 hours a week on average (SD = 15.5, range: 33-40). Participants reported that, on average, their daily voice use is 6.3 hours (SD = 2.7) for work and the majority (81%) reported a decrease in voice quality after work; Three-quarters (75%) also reported vocal fatigue at the end of day. Approximately one-third (33%) reported being exposed to environments where they are expected to shout, scream or cheer loudly. More than half of the participants (61%) reported that they have previously received vocal health education but 40% reported that they felt this training was insufficient. High vocal demands are significantly correlated to an increase in perceived vocal handicap rs = 0.242; (P = 0.018), tiredness of voice rs = 0.270; (P = 0.008), physical discomfort rs = 0.217; (P = 0.038) as well as how occupational voice users experience improvement of symptoms with rest rs = -0.356 (P < 0.001). Other risk factors highlighted by occupational voice users are the ingestion of liquid caffeine, alcohol, and carbonated drinks, smoking or the presence of chronic cough, chronic laryngitis, and gastroesophageal reflux disease. CONCLUSIONS Occupational voice users are subjected to high daily vocal demands that can be seen to be linked to vocal fatigue, changes in voice quality and vocal symptoms experienced. It is essential that occupational voice users as well as treating clinicians are aware of certain significant predictors of both vocal handicap and vocal fatigue. These findings provide insights for developing strategies for training and cultivating vocal health consciousness and preventive voice care initiatives that focus on occupational voice users in South Africa.
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Affiliation(s)
- Rouxjeanne Vermeulen
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Hatfield, Pretoria, South Africa.
| | - Maria du Toit
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Hatfield, Pretoria, South Africa
| | - Kristiane van Lierde
- Department of Speech, Language and Hearing sciences, University of Ghent, Ghent, Belgium
| | - Marien Alet Graham
- Department of Science, Mathematics and Technology Education, University of Pretoria, Groenkloof, Pretoria, South Africa
| | - Jeannie van der Linde
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Hatfield, Pretoria, South Africa
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13
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Nacci A, Capobianco S, Mazzoni L, Fattori B, Barillari MR, Genovese E, Berrettini S, Bastiani L. Development of a New Self-Assessment Tool for Laryngopharyngeal Reflux Screening in Singers (SVHI-12-LPR). Folia Phoniatr Logop 2023; 75:284-294. [PMID: 36822157 DOI: 10.1159/000529800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 02/16/2023] [Indexed: 02/25/2023] Open
Abstract
INTRODUCTION The present study aimed to develop a new tool for the evaluation of singers with self-reported symptoms suggestive of laryngopharyngeal reflux (LPR) (the SVHI-12-LPR), by correlating RSI with SVHI in a population sample of 163 subjects (both professional and amateur singers), evaluated also by videolaryngostroboscopy. This study was a cross-sectional, double-observational study. METHODS RSI and SVHI were administered to 159 singers (amateurs, singing students, and professional singers). All subjects underwent videolaryngostroboscopy to objectively identify four subgroups: normal subjects (41.5%), subjects with organic lesions occupying the glottic space (17.6%), subjects with functional dysphonia (18.2%), and subjects presenting solely signs suggestive of LPR (22.6%). Using the validated RSI threshold, 33.9% of participants presented an RSI total score >13, suggestive of LPR. RESULTS Subjects with a suspected diagnosis of LPR at videolaryngostroboscopy presented a mean RSI significantly higher than other subgroups (p < 0.001). Moreover, the SVHI-36 score did not statistically differ between pathological subgroups. A significant positive relationship was observed between RSI and SVHI total score (Spearman's rank correlation coefficient [ρ] = 0.474, p < 0.001). 12 SVHI items (items 1, 2, 4, 5, 6, 7, 12, 20, 24, 25, 26, 30) showed a significant association with RSI pathology classification. Statistical analysis demonstrated for the 12 selected items (SVHI-12-LPR) acceptable specificity (0.691) and sensibility (0.833) for the suspected diagnosis of LPR with a cut-off of 15. CONCLUSIONS From the SVHI-36, 12 items were extracted that correlated with the specific impact that LPR has on the singer's voice (SVHI-12-LPR), as evaluated by RSI and videolaryngostroboscopy. Such questionnaire represents a new tool that could be applied to singers with symptoms suggestive of LPR to select which patients would benefit from a further phoniatric and videolaryngostroboscopic evaluation.
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Affiliation(s)
- Andrea Nacci
- ENT, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy
| | - Silvia Capobianco
- ENT, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy
| | - Laura Mazzoni
- Department of Diagnostic, Clinical and Public Health, Audiology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Bruno Fattori
- ENT, Audiology and Phoniatrics Unit, University of Pisa, Pisa, Italy
| | - Maria Rosaria Barillari
- Department of Mental and Physical Health and Preventive Medicine, "L. Vanvitelli" University, Naples, Italy
| | - Elisabetta Genovese
- Department of Diagnostic, Clinical and Public Health, Audiology Unit, University of Modena and Reggio Emilia, Modena, Italy
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The Impact of Personal Protective Equipment on Speech Discrimination and Verbal Communication in the Operating Room and the Role of Audio Communication Devices. Simul Healthc 2023; 18:64-70. [PMID: 35307712 DOI: 10.1097/sih.0000000000000646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Recent work has highlighted communication difficulties when wearing personal protective equipment (PPE) in the clinical setting, but currently, there are little objective data on its effects. We assessed the impact of PPE on verbal communication in a simulated operating room and evaluated use of an audio communication device. METHODOLOGY Frontline health professionals across specialties including surgery, anesthetics, and nursing undertook speech discrimination testing with and without standardized levels of PPE in a simulated operating room environment. Background noise (30- and 70-a-weighted decibel multitalker babble) at 2 distances (2 and 4 m) were selected representative of operating room environments. Bamford-Kowal-Bench (BKB) scoring (192 sentences per participant) was performed. A Digital Multichannel Transceiver System (DMTS) was evaluated. We assessed the effects of PPE use, distance, and use of the DMTS with pairwise comparisons, using a Bonferroni correction, and assessed participant experience via Likert scales. RESULTS Thirty-one healthcare professionals were tested. Without PPE in 70-a-weighted decibel "babble," median BKB sentence scores were 90% and 76% at 2 and 4 m (adjusted P < 0.0005). The median BKB sentence scores dropped to 8% and 4% at 2 and 4 m in PPE (adjusted P < 0.0005). Improved speech discrimination was achieved with DMTS use to 70% and 76% at 2 and 4 m. Personal protective equipment led to a statistically significant reduction in BKB scores across all conditions compared with baseline. Overall participant confidence in PPE clinical communication was low. CONCLUSIONS Addition of PPE dramatically impairs speech discrimination and communication in high levels of background noise characteristic of clinical environments, which can be significantly improved using DMTS. Measures should be taken by teams through both through reduction of background noise and consideration of assistive technologies maximizing patient safety. This may be further rehearsed in a simulation environment.
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Hamdan AL, Abi Zeid Daou C, Ghanem A, Ar Feghali P, Hosri J, Sataloff RT. Office-based Laser Therapy in Reinke's Edema: A Systematic Review and Meta-analysis. J Voice 2023:S0892-1997(22)00392-7. [PMID: 36681567 DOI: 10.1016/j.jvoice.2022.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To analyze voice outcomes and lesion regression in patients with Reinke's edema treated in the office with lasers. STUDY DESIGN Systematic review and meta-analysis METHODS: The search was performed in the Medline, Embase, Medline, Cochrane, and Google Scholar databases using the PRISMA framework. There were no limitations to the year of publication and the search included studies looking at voice outcomes and lesion evolution of in-office laser treatment for Reinke's edema measured through voice-handicap index, acoustic analysis or aerodynamics measures. Risk of bias was assessed using Cochrane's ROBINS-I tool for observational studies. Data analysis was performed SPSS software with a significance level of 5%. RESULTS The initial search identified 650 articles, 6 of which met the inclusion criteria and were analyzed. The total number of participants was 58. Meta-analysis showed significant improvement in VHI-10 scores after in-office laser therapy (95% CI, [-1.46; -0.75]). It also showed significant improvement in jitter, significant increase in fundamental frequency (95% CI, [0.52; 1.71]) and significant decrease in lesion size (95% CI, [-2.03; -0.35]). CONCLUSION Office-based laser therapy is a reliable alternative to the traditional phono-microsurgery performed in the operating room. Patients show significant improvement in voice outcomes and laryngeal examination.
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Affiliation(s)
- Abdul-Latif Hamdan
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut, Beirut, Lebanon; Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine; Lankenau Institute for Medical Research..
| | - Christophe Abi Zeid Daou
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut, Beirut, Lebanon; Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine; Lankenau Institute for Medical Research
| | - Anthony Ghanem
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut, Beirut, Lebanon; Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine; Lankenau Institute for Medical Research
| | - Patrick Ar Feghali
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut, Beirut, Lebanon; Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine; Lankenau Institute for Medical Research
| | - Jad Hosri
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut, Beirut, Lebanon; Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine; Lankenau Institute for Medical Research
| | - Robert T Sataloff
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut, Beirut, Lebanon; Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine; Lankenau Institute for Medical Research
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16
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Jayakumar T, Yasin HAM, Benoy JJ. Prevalence of Voice Problems and Associated Risk Factors Among Tamil-Speaking Imams. J Voice 2022:S0892-1997(22)00375-7. [PMID: 36517326 DOI: 10.1016/j.jvoice.2022.11.022] [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: 10/28/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Voice of Professional Voice Users (PVUs) are of particular interest to practicing Speech-Language Pathologists. There is a dearth of studies concerning the prevalence of voice disorders and the associated risk factors among Tamil-speaking Imams. We address this research gap using non-experimental survey research. METHODS A questionnaire was framed by reviewing earlier literature. The derived questionnaire was administered to one hundred Tamil-speaking Imams actively involved in religious service in Tamil Nadu. We analyzed the obtained responses quantitatively and qualitatively. We also examined the effect of age on the prevalence of voice disorders and associated risk factors. RESULTS Based on survey responses, the career prevalence of voice problems among Tamil-speaking Imams was as high as 89%, and the point prevalence was 64%. The general health status of the Imams were good. However, vocal health was not satisfactory. This study identified several factors that contribute to voice problems, such as constant use of loud voice, acid reflux, unhealthy vocal habits, and insufficient hydration. A positive aspect observed during this study was the absence of smoking and consumption of alcohol among Imams. Even though the Imams presented good awareness of the voice production mechanism, they reported not seeking medical help when facing a voice problem. Current findings report a minimal impact of age-related differences on associated risk factors for voice disorders among the Imams. CONCLUSIONS Voice disorders are prevalent among Tamil-speaking Imams. Several risk factors leading to voice disorders among these individuals need to be addressed.
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Affiliation(s)
- Thirunavukkarasu Jayakumar
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, University of Mysore, Mysuru, Karnataka, India.
| | - Hasan Ali Mohamed Yasin
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, University of Mysore, Mysuru, Karnataka, India
| | - Jesnu Jose Benoy
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, University of Mysore, Mysuru, Karnataka, India
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17
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Abdelgoad A, Alrusayyis D. Efficacy of the Accent Method of Voice Therapy in Professional Voice Users with Minimal Associated Pathological Lesions of the Vocal Folds. Indian J Otolaryngol Head Neck Surg 2022; 74:5151-5159. [PMID: 36742497 PMCID: PMC9895492 DOI: 10.1007/s12070-021-03035-4] [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: 07/01/2021] [Accepted: 12/07/2021] [Indexed: 02/07/2023] Open
Abstract
Aims Minimal associated pathological lesions (MAPLs) of the vocal folds are a group of benign disorders commonly related to phonotraumatic conditions and behaviors. Voice therapy (VT) can play a major role in readjusting these maladaptive behaviors and improve overall voice quality, thereby replace surgical intervention in some cases or act as a complementary treatment to enhance the ultimate therapeutic outcomes. This study aims to explore the short-term effect of the Accent method of VT on vocal subjective measures and acoustics in professional users with MAPLs, evaluate the responsiveness of each vocal fold lesion to the VT, and propose a simple model for providing VT to a sector of the population in great need of non-invasive management. Materials and methods This analytical cross-sectional included fifty professional voice users with different MAPLs were exposed to multidimensional voice assessments before and after receiving VT training in a tertiary care hospital. These assessments include GRBAS score, Multidimensional Voice Program (MDVP) and validated Arabic version Voice Handicap Index (VHI-30). Results This study showed variable positive effects of VT on the different types of MAPLs. Cysts had the highest level of responsiveness to VT in comparison to other lesions, followed by nodules, polyps, contact granuloma, and Reinke's edema. Conclusions VT is a substantial solution for managing voice disorders. It should be considered in the management plan of the various types of MAPLs, even in Reinke's edema, which showed the minimum improvement.
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Affiliation(s)
- Ahmed Abdelgoad
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Dammam, Saudi Arabia
| | - Danah Alrusayyis
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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18
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Cordano VP, Álvarez ML, Cabrera JM, Napolitano CA. Acute Vocal Fold Hemorrhage: Retrospective Analysis in a Voice Unit. J Voice 2022:S0892-1997(22)00225-9. [PMID: 36180274 DOI: 10.1016/j.jvoice.2022.07.023] [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: 06/10/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To describe our experience in diagnosis, evaluation, management and evolution of adult patients diagnosed with vocal fold hemorrhage (VFH) in the Voice Unit at Universidad Católica Clinical Hospital Santiago, Chile. STUDY DESIGN Retrospective chart review. METHODS Adult patients diagnosed with VFH between 2012 and 2020 were included. Demographic data, medical and vocal history, vocal symptoms and questionnaires, laryngeal videostroboscopy, treatment, and follow-up controls were reviewed. RESULTS A total of 34 patients were included, 52.9% (18) patients were female and 47.1% (16) male. Mean age was 42 years (22-76 years) and 47.1% were professional voice users. Principal voice symptoms were dysphonia (32/34), vocal fatigue (21/34) and throat clearing (17/34). Twenty-six (76.5%) patients had VFH and a concomitant lesion in the same vocal fold (VF), being a hemorrhagic polyp the most prevalent associated lesion (61.8%). All patients were managed initially with voice rest, showing improvement at first follow up visit according to VRQOL-STD (mean difference -32.43, P = 0.009) and VHI-10 (mean difference 11.22, P = 0.036), and laryngeal videostroboscopic resolution in 66.7% (8/12) at a mean 12.5 (range 6-30) days. CONCLUSIONS VFH is an infrequent phonotraumatic condition. More studies are needed to advance in knowledge of this pathology as there is contradictory evidence in the literature regarding predisposing factors, evolution and prognosis of this condition.
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Affiliation(s)
- Valentina P Cordano
- Otolaryngology Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Matías L Álvarez
- Otolaryngology Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - José M Cabrera
- Otolaryngology Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carla A Napolitano
- Otolaryngology Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Kalman Filter Implementation of Subglottal Impedance-Based Inverse Filtering to Estimate Glottal Airflow during Phonation. APPLIED SCIENCES-BASEL 2021; 12. [PMID: 36313121 PMCID: PMC9615581 DOI: 10.3390/app12010401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Subglottal Impedance-Based Inverse Filtering (IBIF) allows for the continuous, non-invasive estimation of glottal airflow from a surface accelerometer placed over the anterior neck skin below the larynx. It has been shown to be advantageous for the ambulatory monitoring of vocal function, specifically in the use of high-order statistics to understand long-term vocal behavior. However, during long-term ambulatory recordings over several days, conditions may drift from the laboratory environment where the IBIF parameters were initially estimated due to sensor positioning, skin attachment, or temperature, among other factors. Observation uncertainties and model mismatch may result in significant deviations in the glottal airflow estimates; unfortunately, they are very difficult to quantify in ambulatory conditions due to a lack of a reference signal. To address this issue, we propose a Kalman filter implementation of the IBIF filter, which allows for both estimating the model uncertainty and adapting the airflow estimates to correct for signal deviations. One-way analysis of variance (ANOVA) results from laboratory experiments using the Rainbow Passage indicate an improvement using the modified Kalman filter on amplitude-based measures for phonotraumatic vocal hyperfunction (PVH) subjects compared to the standard IBIF; the latter showing a statistically difference (p-value = 0.02, F = 4.1) with respect to a reference glottal volume velocity signal estimated from a single notch filter used here as ground-truth in this work. In contrast, maximum flow declination rates from subjects with vocal phonotrauma exhibit a small but statistically difference between the ground-truth signal and the modified Kalman filter when using one-way ANOVA (p-value = 0.04, F = 3.3). Other measures did not have significant differences with either the modified Kalman filter or IBIF compared to ground-truth, with the exception of H1–H2, whose performance deteriorates for both methods. Overall, both methods (modified Kalman filter and IBIF) show similar glottal airflow measures, with the advantage of the modified Kalman filter to improve amplitude estimation. Moreover, Kalman filter deviations from the IBIF output airflow might suggest a better representation of some fine details in the ground-truth glottal airflow signal. Other applications may take more advantage from the adaptation offered by the modified Kalman filter implementation.
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Kryukov AI, Romanenko SG, Pavlikhin OG, Lesogorova EV, Krasnikova DI, Eliseev OV. [Chronic catarrhal laryngitis in singers]. Vestn Otorinolaringol 2021; 86:33-37. [PMID: 33929149 DOI: 10.17116/otorino20218602133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The article deals with optimization of treatment policy for singers with chronic catarrhal laryngitis. The survey sample is 51 singers with chronic catarrhal laryngitis of the age from 29 to 54 and the length of time worked from 8 to 22 years. The following methods are used: anamnesis, microbiological investigation, voice evaluation according to Visual Analog Scale (VAS), microlaryngoscopy, videolaryngostroboscopy, voice acoustic analysis (MDVP Kay Pentax system), statistical processing of results. It is shown that the cause of chronic catarrhal laryngitis in professional singers is non-bacterial irritants that provoke the appearance of an inflammatory process in the larynx, as well as uncontrolled use of drugs that irritate and dry out the mucous membrane and imperfect vocal technique. Pathogenic flora as an etiologic factor in the occurrence of laryngitis does not play an important role. A comprehensive treatment scheme for chronic catarrhal laryngitis using inhalation therapy and drugs that improve trophic processes in the laryngeal mucosa, which allows to increase the effectiveness of treatment and achieve stable remission of the disease, is suggested.
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Affiliation(s)
- A I Kryukov
- L.I. Sverzhevskiy Research and Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia.,N.I. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - S G Romanenko
- L.I. Sverzhevskiy Research and Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia
| | - O G Pavlikhin
- L.I. Sverzhevskiy Research and Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia
| | - E V Lesogorova
- L.I. Sverzhevskiy Research and Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia
| | - D I Krasnikova
- L.I. Sverzhevskiy Research and Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia
| | - O V Eliseev
- L.I. Sverzhevskiy Research and Clinical Institute of Otorhinolaryngology of the Moscow Healthcare Department, Moscow, Russia
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Marler H, Ditton A. "I'm smiling back at you": Exploring the impact of mask wearing on communication in healthcare. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:205-214. [PMID: 33038046 PMCID: PMC7675237 DOI: 10.1111/1460-6984.12578] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 05/12/2023]
Abstract
BACKGROUND Surgical and respirator masks are worn to reduce the risk of droplet and airborne transmission of viral respiratory disease. As a result of the novel coronavirus (COVID-19) pandemic, mask wearing has been designated mandatory for healthcare professionals working in UK hospitals for the foreseeable future. It is thus timely to consider the long-term implications of mask wearing on communication within healthcare settings, from both a patient and a clinician perspective. AIMS The primary objective is to identify research evidence that corresponds to the mask-wearing experiences of healthcare professionals working on the ground. By drawing together a summary of the literature illustrating the potential challenges associated with mask wearing, it is possible to make an application to various clinical cohorts and to formulate a set of preliminary, evidence-based support strategies. The paper additionally explores the role for the Speech and Language Therapist (SLT) in supporting communication in the context of mask wearing. METHODS & PROCEDURES Through a scoping review of the relevant literature, this paper reflects holistically on the prospective challenges associated with mask wearing across a variety of healthcare settings and patient populations. The subsequent conclusions have been used to inform the proposed clinical guidelines for safe and effective practice. OUTCOMES & RESULTS There is a current research gap with regards to mask wearing in non-medical and non-clinical healthcare workers, and the impact this may have on both a professional and a personal basis. In the absence of preliminary data, the development of associated communication support strategies is hindered. This paper draws upon a variety of clinically conceivable issues faced by healthcare professionals, outlines important practical and ethical considerations, and proposes evidence-based solutions to some of the challenges identified. Future research is required to gather evidence with regards to actual clinical experiences of mask wearing to substantiate hypotheses. CONCLUSIONS & IMPLICATIONS Although undoubtedly essential in protecting the health of staff and patients, there are numerous logistical, physiological, psychological, social and economic complications associated with the wearing of masks. The ability of healthcare staff to successfully communicate with patients and with colleagues is jeopardized, which may adversely affect the efficiency, effectiveness, equitability and, most notably, safety of therapeutic intervention. The SLT has a distinct role in facilitating communication in order to safeguard the provision, accessibility and efficacy of services. What this paper adds What is already known on the subject Existing research explores the impact of mask wearing on medical doctors, surgeons and dentists, and upon the corresponding patient cohorts. Little is known about how mask wearing may affect Allied Health Professionals and their ability to deliver therapeutic interventions safely and effectively. With mandatory face covering potentially a long-term requirement for UK healthcare staff, it is both timely and relevant to consider the consequences of mask wearing on communication across acute and community settings. What this paper adds to existing knowledge This paper identifies a range of prospective key issues associated with mask wearing across a variety of clinical and non-clinical populations, with application specifically to vulnerable patient cohorts. Through evidence synthesis, this paper provides a summary of fundamental issues supported by relevant literature, and draws upon these in order to propose a preliminary set of evidence-based clinical guidelines setting out potential solutions to the challenges faced. This review additionally assists in quantifying the role of the SLT within these extraordinary circumstances, with the aim of prompting unified practice, building upon professional guidance and increasing skill recognition. What are the potential or actual clinical implications of this work? In addition to their role in facilitating the development of individualised communication strategies for patients, SLTs should actively seek to provide widely accessible multidisciplinary education opportunities focusing on supporting communication; with specific reference to mask wearing and the associated communicative challenges. At a commissioning and managerial level, leaders within healthcare should acknowledge mask wearing as just one of the complexities associated with frontline working in the context of the COVID-19 pandemic, and aim to support their workforce by delivering resources and protocols which maximize and promote staff safety, efficiency, resilience and well-being in concurrence with positive patient outcomes.
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Affiliation(s)
| | - Annabel Ditton
- Colman Centre for Specialist Rehabilitation ServicesNorwichUK
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Nacci A, Bastiani L, Barillari MR, Martinelli M, Lechien JR, Simoni F, Berrettini S, Fattori B. Reflux Symptom Index (RSI) and Singing Voice Handicap Index (SVHI) in Singing Students: A Pilot Study. J Voice 2020; 36:288.e25-288.e34. [PMID: 32553500 DOI: 10.1016/j.jvoice.2020.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/08/2020] [Accepted: 05/18/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To correlate, RSI with SVHI, in a group of singing students, by means of a specific anamnestic questionnaire which analyzes the physical, social, emotional, and economic impacts of voice problems on their lives. This study is a cross-sectional single-center observational study. METHODS Forty-two modern singing students (26F/16M; average age: 24.9 ± 5.7; range: 16-46 years old) were recruited. A self-assessment of the singing-voice (SVHI) and of reflux symptom (RSI) was performed. RESULTS Using the validated RSI threshold, 31% of participants were classified as RSI greater than 13 as an indication of suspected LPR. Classifying the SVHI score as proposed in the recent literature (cutoff of 20.35) our sample was a voice disorders prevalence of 71.4%. There was no significant positive or negative relationship between RSI and SVHI total score (rho = 0.238, P = 0.13). Instead, by considering the relationship between the individual items of the two questionnaires, it is highlighted that the item 1 of SVHI was significantly correlated with most of the RSI items (P = 0.0001-0.006). In the same vein, the item 5 of SVHI was correlated to hoarseness and coughing (P = 0.005-0.006). The item 20 of SVHI was significantly correlated with hoarseness, excess mucus in the throat or postnasal drip and with the pharyngeal Globus sensation (P = 0.001-0.005). By aggregating the SVHI item response as a positive response (2-4) versus a negative response (0 or 1) between "RSI pathology classification," a significant association was observed for SVHI item 1 (P < 0.021), item 5 (P < 0.006), item 20 (P < 0.042), item 24 (P < 0.044) item 25 (P < 0.047). These associations were confirmed by univariate binary logistic. Multivariate binary logistic regression confirms that SVHI Item 1, Item 5 were more associated with RSI positive. Based on results, we propose a questionnaire that combines the most relevant SVHI items correlated to LPRD (SVHI-10-LPRD questionnaire). Cronbach's alpha coefficient for the 10 items selected was 0.87; item-total correlation coefficients for each item were in the range of 0.461 to 0.670. CONCLUSIONS This pilot study shows that, in case of significant RSI for LPR, it is possible to observe a significant association with some symptoms described in SVHI. These results underline that the association of the RSI and SVHI questionnaires administered to singers and singing students, can represent a simple screening to reveal possible alterations of the singing voice correlate to LPR. Moreover, we propose a Singing Voice Handicap Index correlated to LPR (SVHI-10-LPRD). It will be necessary to increase the sample of subjects in the study to confirm these preliminary data.
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Affiliation(s)
- Andrea Nacci
- ENT Audiology Phoniatric Unit, University of Pisa, Pisa, Italy; Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France.
| | - Luca Bastiani
- CNR Institute of Clinical Physiology, Epidemiology Section, Pisa, Italy
| | - Maria Rosaria Barillari
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France; Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, Luigi Vanvitelli University, Naples, Italy
| | - Massimo Martinelli
- CNR Institute of Information Science and Technologies, Signals & Images Lab, Pisa, Italy
| | - Jerome R Lechien
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France; Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, University of Paris Saclay, Paris, France
| | - Federica Simoni
- ENT Audiology Phoniatric Unit, University of Pisa, Pisa, Italy
| | - Stefano Berrettini
- ENT Audiology Phoniatric Unit, University of Pisa, Pisa, Italy; Division of ENT Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Bruno Fattori
- ENT Audiology Phoniatric Unit, University of Pisa, Pisa, Italy
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Rimoli CF, Macedo Filho ED, Patrial MTCRO, Klas CF, Nascimento GA. Profile of Laryngeal Microsurgeries in Patients Over 60 Years Old. Int Arch Otorhinolaryngol 2020; 24:e53-e61. [PMID: 31929834 PMCID: PMC6952290 DOI: 10.1055/s-0039-1698780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 09/07/2019] [Indexed: 11/07/2022] Open
Abstract
Introduction
The increase in life expectancy is an incentive to the development of researches with the elderly population aiming at actions that may ensure healthy and active aging.
Objective
To analyze the profile of laryngeal microsurgery performed in patients > 60 years old.
Methods
A retrospective observational study, with a cross-sectional design. A retrospective analysis of the medical records of elderly patients submitted to laryngeal microsurgery was performed at a private hospital in Curitiba, state of Paraná, Brazil, between January 2004 and December 2016. Were included all of the patients > 60 years old that underwent laryngeal microsurgery during this period.
Results
During the studied period, 213 laryngeal microsurgeries were performed in 181 patients > 60 years old. There was a preponderance of male patients. The mean age was 67.6 years old. Squamous cell carcinoma (SCC) was the most prevalent disorder (26%), followed by Reinke edema (20%), papillomatosis (14%), polyps (11%), leukoplakia (8%), minor structural alterations (8%), associated lesions (9%), and others (4%). Men presented a higher probability of SCC diagnosis, regardless of the age group, while Reinke edema was more frequently observed in women. A directly proportional relation between the frequency of laryngeal cancer and age increase was also observed. No significant differences were observed in professional voice users.
Conclusion
Further researches are required to properly comprehend the factors associated with laryngeal lesions and determine prevention and treatment approaches.
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Application of Thulium Laser as Office-based Procedure in Patients With Vocal Fold Polyps. J Voice 2020; 34:140-144. [DOI: 10.1016/j.jvoice.2018.08.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/15/2018] [Accepted: 08/27/2018] [Indexed: 11/23/2022]
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Ramani S, Kumar Balasubramanium R, Gunjawate D. Vocal and Nonvocal Habits among Vedic Chanters. Folia Phoniatr Logop 2019; 73:7-14. [DOI: 10.1159/000503563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/18/2019] [Indexed: 11/19/2022] Open
Abstract
<b><i>Objectives:</i></b> The objective of the present study was to explore the voice concerns and vocal and nonvocal habits of Vedic chanters. <b><i>Participants and Method:</i></b> A cross-sectional design was used to study 200 Vedic chanters using a 36-item questionnaire. This questionnaire was developed and administered to explore their voice concerns and vocal and nonvocal habits. Descriptive statistics were used to summarize the findings and K-means cluster analysis was carried out to identify clusters concerning voice quality and influence of habits. <b><i>Results:</i></b> The majority of Vedic chanters were involved in certain vocal habits such as use of loud voice while chanting and frequent throat clearing. Further, approximately half of the chanters expressed a concern towards their voice, while a vast majority experienced vocal fatigue. Cluster analysis helped in identification of 4 clusters: Vedic chanters with (1) good lifestyle and good voice characteristics (<i>n</i> = 107), (2) good lifestyle but bad voice characteristics (<i>n</i> = 15), (2) poor lifestyle and good voice characteristics (<i>n</i> = 51), and (4) poor lifestyle leading to bad voice characteristics (<i>n</i> = 27). <b><i>Conclusion:</i></b> The findings of the present study provide useful information on voice concern and vocal and nonvocal habits among a unique population of individuals. The current study of Vedic chanters highlights the need to have a detailed understanding of their specific voice usage, demands, and voice characteristics.
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Lenti MV, Cammarota G, Vidali F, Masala G, Bendinelli B, Gasbarrini G, Corazza GR, Di Sabatino A. Reflux symptoms in professional opera soloists. Dig Liver Dis 2019; 51:798-803. [PMID: 30578108 DOI: 10.1016/j.dld.2018.11.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 11/09/2018] [Accepted: 11/13/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Professions distinguished by repeated vocal stress carry a high risk of developing gastroesophageal reflux symptoms (GERS) which may affect vocal performance. AIMS To investigate the prevalence of self-reported GERS in professional opera soloists. METHODS A validated questionnaire regarding self-reported GERS (heartburn, regurgitation, chest pain, dysphagia, hoarseness, and cough) and lifestyle habits was administered to 116 professional opera soloists (mean age 34.1 ± 7.3 years, F:M ratio 1:1.1). Age and sex-matched opera choristers and control subjects were used as control. Prevalence rate ratios (PRRs) adjusted for confounding factors were evaluated. RESULTS Among GERS, belching (33.6%), heartburn (19.8%), and dysphagia (15.5%) were the most commonly reported by soloists. In particular, a higher risk of heartburn (PRR 2.61, 95% CI 1.45-4.69) and dysphagia (PRR 2.58, 95% CI 1.31-5.10) was reported in soloists as compared to choristers. The prevalence of obesity and late dinner was higher in both choristers and soloists in comparison to the population sample (p < 0.001). GERS was more common among soloists who received pharmacologic treatment and their prevalence was unrelated to the years of singing activity. CONCLUSIONS Professional opera soloists, regardless of the length of their career, are predisposed to developing GERS. Physicians should encourage patients to correct preventable risk factors. A prolonged pharmacological treatment might be needed.
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Affiliation(s)
- Marco Vincenzo Lenti
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Giovanni Cammarota
- Institute of Internal Medicine, Catholic University of Medicine and Surgery, Rome, Italy
| | - Francesca Vidali
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Giovanna Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Benedetta Bendinelli
- Cancer Risk Factors and Lifestyle Epidemiology Unit Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Giovanni Gasbarrini
- Institute of Internal Medicine, Catholic University of Medicine and Surgery, Rome, Italy
| | - Gino Roberto Corazza
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Antonio Di Sabatino
- First Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
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Look C, McCabe P, Heard R, Madill CJ. Show and Tell: Video Modeling and Instruction Without Feedback Improves Performance but Is Not Sufficient for Retention of a Complex Voice Motor Skill. J Voice 2019; 33:239-249. [DOI: 10.1016/j.jvoice.2017.09.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 09/26/2017] [Accepted: 09/27/2017] [Indexed: 10/18/2022]
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Nacci A, Baracca G, Romeo SO, Cavaliere MD, Barillari MR, Berrettini S, Ursino F, Fattori B. Endoscopic and Phoniatric Evaluation in Singing Students. J Voice 2019; 33:135-142. [DOI: 10.1016/j.jvoice.2017.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/02/2017] [Accepted: 10/05/2017] [Indexed: 10/18/2022]
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Büyükatalay ZC, Gökmen MF, Yıldırım S, Dursun G. Voice Disorders in Islamic Religious Officials: Is It Any Different Than Those of the Teachers, Another Well-Known Professional Voice Users? J Voice 2019; 34:738-742. [PMID: 30797630 DOI: 10.1016/j.jvoice.2019.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study explores Islamic religious officials' voice use, disorders, and treatment methods by comparing the officials with teachers, the largest group of voice professionals. STUDY DESIGN This is a nonrandomized retrospective study. METHODS This study included 85 patients with voice disorder complaints; 42 were religious officials and 43 were teachers. We compared the two groups of patients in terms of demographic information, job descriptions, years in their professions, smoking histories, alcohol consumption, allergies and other systemic disorders, average weekly vocal loads, voice training, vocal abuse-misuse, reflux symptom index and voice handicap index scores, and voice disorder diagnosis and treatment methods. RESULTS The study compared 39 male (92.85%) and three female (7.14%) religious officials with five male (11.62%) and 38 female (88.37%) teachers. The alcohol use, systemic diseases, and vocal loads were found to be statistically higher in the teachers than the religious officials (P < 0.05), while the vocal abuse-misuse, vocal hygiene knowledge, and voice handicap indices were determined to be statistically higher in the religious officials than the teachers (P < 0.05). A statistically significant difference in the distribution of the diagnoses exists between the two groups (P < 0.005). Voice therapy is the most common treatment method in both groups. CONCLUSIONS Like teachers, Islamic religious officials appear to be at high risk of developing voice disorders. Because of the lack of research on the frequency of voice disorders among Islamic religious officials, it is important to raise awareness of the prevalence of voice disorders.
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Affiliation(s)
- Zahide Ciler Büyükatalay
- Department of Otorhinolaryngology, Head and Neck Surgery, Ibni Sina Hospital, Ankara University School of Medicine, Ankara, Turkey
| | - Muhammed Fatih Gökmen
- Department of Otorhinolaryngology, Head and Neck Surgery, Ibni Sina Hospital, Ankara University School of Medicine, Ankara, Turkey
| | - Sibel Yıldırım
- Department of Otorhinolaryngology, Head and Neck Surgery, Ibni Sina Hospital, Ankara University School of Medicine, Ankara, Turkey
| | - Gürsel Dursun
- Department of Otorhinolaryngology, Head and Neck Surgery, Ibni Sina Hospital, Ankara University School of Medicine, Ankara, Turkey
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Chitguppi C, Raj A, Meher R, Rathore P. Is the Voice of Professional Voice Users With no Vocal Cord Lesions Similar to That of Non Professional Voice Users? J Voice 2019; 33:66-72. [DOI: 10.1016/j.jvoice.2017.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/04/2017] [Accepted: 09/06/2017] [Indexed: 10/18/2022]
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McKinnon-Howe L, Dowdall J. Identifying Knowledge Gaps in Clinicians Who Evaluate and Treat Vocal Performing Artists in College Health Settings. J Voice 2018; 32:385.e7-385.e15. [DOI: 10.1016/j.jvoice.2017.05.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 05/24/2017] [Accepted: 05/25/2017] [Indexed: 11/30/2022]
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Natour YS, Darawsheh WB, Bashiti S, Wari M, Taha J, Odeh T. A study of VHI scores and acoustic features in street vendors as occupational voice users. JOURNAL OF COMMUNICATION DISORDERS 2018; 71:11-21. [PMID: 29223491 DOI: 10.1016/j.jcomdis.2017.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 10/29/2017] [Accepted: 12/03/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE to investigate acoustic features of phonation and perception of voice handicap in street vendors. METHODS Eighty-eight participants (44 street vendors, 44 controls) were recruited. The mean age of the group was 38.9±16.0 years (range: 20-78 years). Scores of the Arabic version of the Voice Handicap Index (VHI-Arab) were used for analysis. Acoustic measures of fundamental frequency (F0), jitter, shimmer, and signal-to-noise ratio (SNR) were also analyzed. RESULTS Analysis showed a significant difference between street vendors and controls in the total score of the VHI-Arab (p<0.001) as well as scores of all three VHI-Arab subsections: functional (p<0.001), physical (p<0.001), and emotional (p=0.025). Weak correlations were found among all of the VHI scores and acoustic measures (-0.219≤ r≤0.355), except for SNR where a moderate negative correlations were found (r=-0.555; -0.4) between the VHI (physical and total) scores and SNR values. Significant differences also were found in F0, jitter, and SNR among specific subgroups of street vendors when stratified by weekly hours worked (p<0.05), and in jitter (p=0.39) when stratified by educational level. CONCLUSIONS Perception of voice handicap and a possible effect on vocal quality in street vendors were noted. The effect of factors, namely work hours and educational level, on voice quality should be further studied.
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Affiliation(s)
- Yaser S Natour
- Department of Hearing and Speech Sciences, School of Rehabilitation Sciences, The University of Jordan, Jordan
| | - Wesam B Darawsheh
- Department of Occupational Therapy, School of Rehabilitation Sciences, The University of Jordan, Jordan.
| | - Sara Bashiti
- The Faculty of Pharmacy, Nursing and Allied Health Professions, Speech Language Pathology and Audiology Department, Birzeit University, Palestine
| | - Majd Wari
- The Faculty of Pharmacy, Nursing and Allied Health Professions, Speech Language Pathology and Audiology Department, Birzeit University, Palestine
| | - Juhayna Taha
- The Faculty of Pharmacy, Nursing and Allied Health Professions, Speech Language Pathology and Audiology Department, Birzeit University, Palestine
| | - Thair Odeh
- The Faculty of Pharmacy, Nursing and Allied Health Professions, Speech Language Pathology and Audiology Department, Birzeit University, Palestine
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Benedict PA, Ruiz R, Yoo M, Verma A, Ahmed OH, Wang B, Dion GR, Voigt A, Merati A, Rosen CA, Amin MR, Branski RC. Laryngeal distribution of recurrent respiratory papillomatosis in a previously untreated cohort. Laryngoscope 2017; 128:138-143. [DOI: 10.1002/lary.26742] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 05/18/2017] [Accepted: 05/22/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Peter A. Benedict
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
| | - Ryan Ruiz
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
| | - MiJin Yoo
- Department of Otolaryngology-Head and Neck Surgery; University of Washington School of Medicine; Seattle Washington
| | - Avanti Verma
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
| | - Omar H. Ahmed
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
| | - Binhuan Wang
- Department of Population Heath, Division of Biostatistics; New York University School of Medicine; New York New York
| | - Gregory R. Dion
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
- Department of Otolaryngology-Head and Neck Surgery; Brooke Army Medical Center; Fort Sam Houston Texas
| | - Andrew Voigt
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
| | - Albert Merati
- Department of Otolaryngology-Head and Neck Surgery; University of Washington School of Medicine; Seattle Washington
| | - Clark A. Rosen
- University of Pittsburgh Voice Center, Department of Otolaryngology; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania U.S.A
| | - Milan R. Amin
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
| | - Ryan C. Branski
- NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York
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Abstract
OBJECTIVE Workplace hazards in the performing arts cause injuries, disabilities, and deaths every year. Occupational health professionals are familiar with most of these hazards and are particularly qualified to contribute to efforts to reduce them. This article reviews current health issues in the performing arts and highlights opportunities for occupational health contributions. METHODS Recognized experts in performing arts medicine were consulted and articles illustrating performing arts health issues were reviewed. Literature sources included medical databases, unindexed art-health publications, and popular press articles. RESULTS Resources discussing hazards and health issues in theater, dance, voice, and instrumental musicians were located and reviewed. CONCLUSIONS Treatment providers have a history of involvement with segments of the performing arts. The occupational health approach to workplace health issues can effectively complement these efforts. Sources of further information on performing arts health concerns are available.
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Adaptation and Validation of the Kannada Version of the Singing Voice Handicap Index. J Voice 2017; 31:507.e7-507.e11. [DOI: 10.1016/j.jvoice.2016.10.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/19/2016] [Accepted: 10/21/2016] [Indexed: 11/19/2022]
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Gunjawate DR, Aithal VU, Devadas U, Guddattu V. Evaluation of Singing Vocal Health in Yakshagana Singers. J Voice 2017; 31:253.e13-253.e16. [DOI: 10.1016/j.jvoice.2016.06.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 10/21/2022]
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Yiu EML, Chan KMK, Kwong E, Li NYK, Ma EPM, Tse FW, Lin Z, Verdolini Abbott K, Tsang R. Is Acupuncture Efficacious for Treating Phonotraumatic Vocal Pathologies? A Randomized Control Trial. J Voice 2016; 30:611-20. [PMID: 26298839 PMCID: PMC4548836 DOI: 10.1016/j.jvoice.2015.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 07/14/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate the effectiveness of acupuncture in treating phonotraumatic vocal fold lesions. STUDY DESIGN/METHODS A total of 123 dysphonic individuals with benign vocal pathologies were recruited. They were given either genuine acupuncture (n = 40), sham acupuncture (n = 44), or no treatment (n = 39) for 6 weeks (two 30-minute sessions/wk). The genuine acupuncture group received needles puncturing nine voice-related acupoints for 30 minutes, two times a week for 6 weeks, whereas the sham acupuncture group received blunted needles stimulating the skin surface of the nine acupoints for the same frequency and duration. The no-treatment group did not receive any intervention but attended just the assessment sessions. One-hundred seventeen subjects completed the study (genuine acupuncture = 40; sham acupuncture = 43; and no treatment = 34), but only 84 of them had a complete set of vocal functions and quality of life measures (genuine acupuncture = 29; sham acupuncture = 33; and no-treatment = 22) and 42 of them with a complete set of endoscopic data (genuine acupuncture = 16; sham acupuncture = 15; and no treatment = 11). RESULTS Significant improvement in vocal function, as indicated by the maximum fundamental frequency produced, and also perceived quality of life, were found in both the genuine and sham acupuncture groups, but not in the no-treatment group. Structural (morphological) improvements were, however, only noticed in the genuine acupuncture group, which demonstrated a significant reduction in the size of the vocal fold lesions. CONCLUSIONS The findings showed that acupuncture of voice-related acupoints could bring about improvement in vocal function and healing of vocal fold lesions.
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Affiliation(s)
- Edwin M L Yiu
- Division of Speech and Hearing Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Karen M K Chan
- Division of Speech and Hearing Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Elaine Kwong
- Division of Speech and Hearing Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Nicole Y K Li
- School of Communication Sciences and Disorders, McGill University, Montreal, Canada
| | - Estella P M Ma
- Division of Speech and Hearing Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Fred W Tse
- Fred TSE's CM Clinic, Causeway Bay, Hong Kong, China
| | - Zhixiu Lin
- School of Chinese Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | | | - Raymond Tsang
- Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong, China
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Woo JH, King SN, Hoffman H, Dailey S, Wang S, Christensen MB, Thibeault SL. MERS versus Standard Surgical Approaches for Porcine Vocal Fold Scarring with Adipose Stem Cell Constructs. Otolaryngol Head Neck Surg 2016; 155:612-23. [PMID: 27165681 DOI: 10.1177/0194599816645772] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 04/01/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Cells, scaffold, and surgical approaches are important for regeneration of the lamina propria of the scarred vocal fold (VF). Microendoscopy of Reinke's space (MERS) is a surgical approach used to access the lamina propria. The present study evaluated MERS in the treatment of VF scarring as compared with standardized approaches for the treatment of VF scarring with adipose stem cell constructs. STUDY DESIGN Animal study. SETTING Academic center. SUBJECTS AND METHODS VF injury was performed bilaterally to induce scarring in 20 pigs. Eight weeks after injury, pigs were classified into no treatment, minithyrotomy, VF injection, VF incision/dissection, and MERS. All groups (except control) were implanted with adipose stem cell and hyaluronan. Four weeks after treatment, histology for collagen, hyaluronan, and fibronectin; mRNA expression for α-smooth muscle actin, tumor growth factor β1, collagen 1α1, collagen 3α1, matrix metalloproteinase 2, basic fibroblast growth factor, and hepatocyte growth factor; and tissue rheology were evaluated. RESULTS Differences were measured among surgical approaches for protein levels of collagen, hyaluronan, and fibronectin (P = .0133, P < .0001, and P = .0025, respectively). Fibroblast growth factor, collagen 1α1, and matrix metalloproteinase 2 transcript levels were different among treatment groups (P = .003, P = .0086, and P = .014, respectively), while no differences were measured for α-smooth muscle actin, tumor growth factor β1, hepatocyte growth factor, and collagen 3α1. Rheologically, significant differences were not measured between groups. CONCLUSION MERS is a promising surgical approach for the treatment of VF scarring, optimizing the placement of implanted biomaterials.
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Affiliation(s)
- Joo Hyun Woo
- Department of Otorhinolaryngology-Head and Neck Surgery, Gil Medical Center, Gachon University, Incheon, Korea
| | - Suzanne N King
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky, USA
| | - Henry Hoffman
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA
| | - Seth Dailey
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Sarah Wang
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Susan L Thibeault
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Glaser R, York A, Dimitrakakis C. Effect of testosterone therapy on the female voice. Climacteric 2016; 19:198-203. [PMID: 26857354 PMCID: PMC4819813 DOI: 10.3109/13697137.2015.1136925] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 12/25/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This prospective study was designed to investigate the effect of testosterone, delivered by subcutaneous implants, on the female voice. METHODS Ten women who had opted for testosterone therapy were recruited for voice analysis. Voices were recorded prior to treatment and at 3 months, 6 months, and 12 months while on testosterone therapy. Acoustic samples were collected with subjects reading a sentence, reading a paragraph, and participating in a conversation. Significant changes in the voice over time were investigated using a repeated-measures analysis of variance with the fundamental frequency (F0) as a response variable. Demographic variables associated with characteristics of the voice were assessed. RESULTS There were no significant differences in average F0 related to smoking history, menopausal status, weight, or body mass index. There was no difference in average fundamental speaking frequency (sentence, paragraph, conversation) between the pre-treatment group and any post-treatment group at 3 and 12 months. There was an increase in sentence speech F0 at 6 months. Two of three patients with lower than expected F0 at baseline improved on testosterone therapy. CONCLUSION Therapeutic levels of testosterone, delivered by subcutaneous implant, had no adverse affect on the female voice including lowering or deepening of the voice.
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Affiliation(s)
- R. Glaser
- Millennium Wellness Center, Dayton and Wright State University Boonshoft School of Medicine, Department of Surgery,
Dayton,
Ohio,
USA
| | - A. York
- York Data Analysis,
Seattle,
WA,
USA
| | - C. Dimitrakakis
- 1st Department of Ob-Gyn, Athens University Medical School, Athens, Greece and National Institutes of Health, NICHD,
Bethesda,
MD,
USA
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Tang CGZ, Askin G, Christos PJ, Sulica L. Vocal fold varices and risk of hemorrhage. Laryngoscope 2015; 126:1163-8. [DOI: 10.1002/lary.25727] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 08/17/2015] [Accepted: 09/15/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Christopher Guan-Zhong Tang
- New York Center for Voice and Swallowing Disorders; Weill Cornell Medical College; New York New York U.S.A
- Sean Parker Institute for the Voice; Department of Otolaryngology-Head and Neck Surgery; Weill Cornell Medical College; New York New York U.S.A
| | - Gülce Askin
- Division of Biostatistics and Epidemiology; Department of Healthcare Policy and Research; Weill Cornell Medical College; New York New York U.S.A
| | - Paul J. Christos
- Division of Biostatistics and Epidemiology; Department of Healthcare Policy and Research; Weill Cornell Medical College; New York New York U.S.A
| | - Lucian Sulica
- Sean Parker Institute for the Voice; Department of Otolaryngology-Head and Neck Surgery; Weill Cornell Medical College; New York New York U.S.A
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Yiu EML, Chan KMK, Li NYK, Tsang R, Verdolini Abbott K, Kwong E, Ma EPM, Tse FW, Lin Z. Wound-healing effect of acupuncture for treating phonotraumatic vocal pathologies: A cytokine study. Laryngoscope 2015; 126:E18-22. [PMID: 26227080 DOI: 10.1002/lary.25483] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/07/2015] [Accepted: 06/05/2015] [Indexed: 01/20/2023]
Abstract
OBJECTIVES/HYPOTHESIS Acupuncture is a less-invasive procedure when compared with surgical treatment for benign vocal pathologies caused by vocal overuse. This study aimed to determine the wound-healing effect of acupuncture in treating phonotraumatic vocal fold lesions. STUDY DESIGN Two-way, mixed-model, between- and within-subjects, prospective randomized, placebo-controlled, blinded group design. METHODS Seventeen dysphonic individuals with vocal nodules were recruited from a university clinic in Hong Kong. Each participant was randomly assigned to receive one session of either genuine or sham acupuncture. The genuine acupuncture group (n = 9) received needles puncturing nine voice-related acupoints for 30 minutes, whereas the sham acupuncture group (n = 8) received blunted needles stimulating the skin surface of the nine acupoints for the same frequency and duration. Laryngeal secretions were suctioned from the surface of the vocal folds immediately before, immediately after, and 24 hours after the acupuncture. The protein concentration levels of wound-healing-related cytokines (interleukin [IL]-1β and IL-10) in these secretion samples were measured. RESULTS Following acupuncture, a significant increase in the anti-inflammatory cytokine IL-10 was found in the genuine acupuncture group (n = 9) but not in the sham acupuncture group (n = 8). CONCLUSIONS The findings showed that acupuncture of voice-related acupoints facilitated an anti-inflammatory process in phonotraumatic vocal pathologies. This could be considered as supporting evidence to consider acupuncture as a less-invasive alternative option, when compared to surgery, for treating phonotraumatic vocal pathologies.
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Affiliation(s)
- Edwin M L Yiu
- Division of Speech & Hearing Sciences, University of Hong Kong, Pokfulam, Hong Kong
| | - Karen M K Chan
- Division of Speech & Hearing Sciences, University of Hong Kong, Pokfulam, Hong Kong
| | - Nicole Y K Li
- School of Communication Sciences and Disorders, McGill University, Montreal, Quebec, Canada
| | - Raymond Tsang
- Department of Surgery, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | | | - Elaine Kwong
- Division of Speech & Hearing Sciences, University of Hong Kong, Pokfulam, Hong Kong
| | - Estella P M Ma
- Division of Speech & Hearing Sciences, University of Hong Kong, Pokfulam, Hong Kong
| | - Fred W Tse
- Fred Tse's CM Clinic, Causeway Bay, Hong Kong
| | - Zhixiu Lin
- School of Chinese Medicine, Chinese University of Hong Kong, Shatin, Hong Kong
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Wang CT, Liao LJ, Huang TW, Lo WC, Cheng PW. Comparison of treatment outcomes of transnasal vocal fold polypectomy versus microlaryngoscopic surgery. Laryngoscope 2014; 125:1155-60. [PMID: 25545269 DOI: 10.1002/lary.25088] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 10/19/2014] [Accepted: 11/17/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Office-based procedures have been proposed for the treatment of vocal polyps, including indirect laryngoscopic surgery and angiolytic laser photocoagulation. Our previous report documented good treatment outcomes by combining the two aforementioned procedures. This study was intended to further compare the treatment outcomes of office transnasal vocal fold polypectomy (VFP) with those of microlaryngoscopic surgery (MLS). STUDY DESIGN A matched cohort study. METHODS This study retrospectively enrolled 50 age-, gender-, and size-matched patients with vocal polyps treated by VFP or MLS at a tertiary teaching hospital from January 2012 to October 2013. Treatment outcomes were evaluated before, 2 weeks, and 6 weeks after the procedures via perceptual rating of voice quality, acoustic measurement of the speech signal, 10-item voice-handicap index, maximal phonation time, subjective rating of voice quality, and videolaryngostroboscopic evaluation. RESULTS Both VFP and MLS resulted in significant clinical improvements 2 and 6 weeks postoperatively. Study results exhibited similar objective outcomes between VFP and MLS, whereas patients who received VFP reported higher subjective voice quality than those receiving MLS 2 weeks postoperatively. Six weeks after the procedures, the objective and subjective treatment outcomes were not significantly different between the two treatment groups. CONCLUSION This study shows that transnasal VFP may be used as an effective alternative treatment for small vocal polyps. Patients who received office VFP experienced rapid symptomatic relief with a higher degree of subjective effectiveness than MLS 2 weeks postoperatively, whereas the overall treatment outcomes showed a comparable level of effectiveness for both modalities. LEVEL OF EVIDENCE 3B.
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Affiliation(s)
- Chi-Te Wang
- Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan; Oriental Institute of Technology, Taipei, Taiwan; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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Rafii B, Taliercio S, Achlatis S, Ruiz R, Amin MR, Branski RC. Incidence of underlying laryngeal pathology in patients initially diagnosed with laryngopharyngeal reflux. Laryngoscope 2013; 124:1420-4. [DOI: 10.1002/lary.24483] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 09/03/2013] [Accepted: 10/18/2013] [Indexed: 01/17/2023]
Affiliation(s)
- Benjamin Rafii
- New York University Voice Center; Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York U.S.A
| | - Salvatore Taliercio
- New York University Voice Center; Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York U.S.A
| | - Stratos Achlatis
- New York University Voice Center; Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York U.S.A
| | - Ryan Ruiz
- New York University Voice Center; Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York U.S.A
| | - Milan R. Amin
- New York University Voice Center; Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York U.S.A
| | - Ryan C. Branski
- New York University Voice Center; Department of Otolaryngology-Head and Neck Surgery; New York University School of Medicine; New York New York U.S.A
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Wang CT, Liao LJ, Lai MS, Cheng PW. Comparison of benign lesion regression following vocal fold steroid injection and vocal hygiene education. Laryngoscope 2013; 124:510-5. [DOI: 10.1002/lary.24328] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 06/25/2013] [Accepted: 07/08/2013] [Indexed: 11/12/2022]
Affiliation(s)
- Chi-Te Wang
- Department of Otolaryngology; Far Eastern Memorial Hospital; Taipei Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health, National Taiwan University; Taipei Taiwan
- Center of Comparative Effectiveness Research; National Center of Excellence for Clinical Trial and Research; National Taiwan University Hospital; Taipei Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology; Far Eastern Memorial Hospital; Taipei Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health, National Taiwan University; Taipei Taiwan
- Center of Comparative Effectiveness Research; National Center of Excellence for Clinical Trial and Research; National Taiwan University Hospital; Taipei Taiwan
| | - Mei-Shu Lai
- Department of Otolaryngology; Far Eastern Memorial Hospital; Taipei Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health, National Taiwan University; Taipei Taiwan
- Center of Comparative Effectiveness Research; National Center of Excellence for Clinical Trial and Research; National Taiwan University Hospital; Taipei Taiwan
| | - Po-Wen Cheng
- Department of Otolaryngology; Far Eastern Memorial Hospital; Taipei Taiwan
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health, National Taiwan University; Taipei Taiwan
- Center of Comparative Effectiveness Research; National Center of Excellence for Clinical Trial and Research; National Taiwan University Hospital; Taipei Taiwan
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Thompson LD. Larynx: Nodules and Polyps. EAR, NOSE & THROAT JOURNAL 2013. [DOI: 10.1177/014556131309200906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Lester D.R. Thompson
- From the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills, Calif
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46
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Baracca G, Cantarella G, Forti S, Pignataro L, Fussi F. Validation of the Italian version of the Singing Voice Handicap Index. Eur Arch Otorhinolaryngol 2013; 271:817-23. [DOI: 10.1007/s00405-013-2658-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 08/13/2013] [Indexed: 11/28/2022]
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Lorenz A, Kleber B, Büttner M, Fuchs M, Mürbe D, Richter B, Sandel M, Nawka T. Validierung des Singing Voice Handicap Index in der deutschen Fassung. HNO 2013; 61:699-706. [DOI: 10.1007/s00106-013-2721-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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48
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Vocal fold hemorrhage: Factors predicting recurrence. Laryngoscope 2013; 124:227-32. [DOI: 10.1002/lary.24242] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/09/2013] [Accepted: 05/09/2013] [Indexed: 11/07/2022]
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de Souza AMV, de Campos Duprat A, Costa RC, de Oliveira Pimenta J, de Sá Andrade FF, da Silva FF. Use of inhaled versus oral steroids for acute dysphonia. Braz J Otorhinolaryngol 2013; 79:196-202. [PMID: 23670326 PMCID: PMC9443858 DOI: 10.5935/1808-8694.20130035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 11/29/2012] [Indexed: 11/30/2022] Open
Abstract
Acute dysphonia is a frequent condition in clinical practice. Its treatment, especially in adults, is not well established in the literature. Steroids are the most recommended drug treatment. However, the existing studies are not enough to establish superiority among the different steroids and the best route of administration. Objective This prospective clinical study aimed at comparing the effect of inhaling steroids as a dry powder with the effect of oral steroids to treat acute dysphonia. Method We assessed 32 adult patients, broken down into two groups of 16 patients in each one of the treatments, before and seven days after the use of the medication. The patients were submitted to videolaryngoscopy and perceptive and acoustic voice assessment. Result Oral and inhalation treatment significantly reduced hyperemia and edema, and improved the muco-ondulatory movement; nonetheless, edema reduction was statistically more significant (p = 0.012) in the patients treated with the inhalation form of the drug. However, comparing the values of the auditory perceptive analysis and the acoustic measures after treatment between the groups was not statistically significant. Conclusion There was a significant improvement in the acute laryngitis concerning the assessments carried out in all the patients assessed, concerning the two treatments. The inhalation steroid treatment was significantly more effective in reducing the edema.
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Affiliation(s)
- Andréa Moreira Veiga de Souza
- MD MSc - Otorhinolaryngologist - Espaço da voz - MG - Brazil
- Send correspondence to: André de Campos Duprat. Av. 9 de Julho, nº 5519, cj 71. Jardim Europa. São Paulo - SP. Brazil. CEP: 01407-200. Fax: (11) 3168-6644
| | - André de Campos Duprat
- MD PhD - Otorhinolaryngologist. Professor at the Medical School of the Santa Casa - São Paulo
| | - Rejane Cardoso Costa
- MD Otorhinolaryngologist - Insttuto de Otorrinolaringologia de Minas Gerais - Brazil
| | - Janaína de Oliveira Pimenta
- MSc - Speech and Hearing Therapist - Espaço da voz - MG - Brazil. Irmandade da Santa Casa de Misericórdia de São Paulo
| | | | - Fernanda Ferreira da Silva
- MSc - Speech and Hearing Therapist - Espaço da voz - MG - Brazil. Irmandade da Santa Casa de Misericórdia de São Paulo
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50
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Dion GR, Miller CL, Ramos RG, O'Connor PD, Howard NS. Characterization of Voice Disorders in Deployed and Nondeployed US Army Soldiers. J Voice 2013; 27:57-60. [DOI: 10.1016/j.jvoice.2012.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Accepted: 08/02/2012] [Indexed: 11/25/2022]
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