Objectives: Unilateral vocal fold palsy independently of etiology results in glottic insufficiency leading to unfavorable short or long-term impact on voice quality. Our aim was to evaluate the ...effect of injection laryngoplasty using Radiesse® Voice and thyroplasty type I on glottic closure, voice quality and aerodynamics by comparing preoperative, short- and long-term results. Materials and Methods: Data of 32 consent patients were reviewed between 2012 and 2023. All patients underwent either injection laryngoplasty (14 patients) or thyroplasty type I (18 patients) under local anesthesia. Maximum phonation time, glottic closure based on videolaryngostroboscopy, VHI-30 values and GRBAS scale were recorded prior, short-term (3 month) and long-term (12 months) after procedures for statistical comparison. Friedman test, Mann-Whitney test and Wilcoxon signed rank tests were used for statistical analysis. Results: In injection laryngoplasty group, we found significant improvement in maximum phonation time (p = 0.002), grade of hoarseness (p = 0.002) and breathiness (p = 0.000) when comparing results before and short-term after procedure. In thyroplasty type I group we saw significant improvement of maximum phonation time (p = 0.000), glottic insufficiency (p = 0.000), all three VHI-30 components (p = 0.000), as well as grade of hoarseness, breathiness (both p = 0.000) and roughness (p = 0.011) of GRBAS scale when comparing voice outcome before and short-term after procedure. There was no significant difference in voice outcome results neither between short and long-term results nor between the two groups in any parameter. Conclusion: These results demonstrate both short and long-term efficiency of injection laryngoplasty and thyroplasty type I in the improvement of voice quality and glottic closure.
Objectives: To describe the impact of neuromuscular electrical stimulation (NMES) on two different types of unilateral vocal fold paralysis (UVFP): in the paramedian and median positions.
Methods: ...Subjects underwent 12-minute-long sessions of NMES for 5 consecutive days (1 hour of intervention in total). A modified electrode placement was used to target the adductor muscles of the larynx. Acoustic, electroglottographic, imaging, auditory-perceptual, and self-perceived data were collected.
Results: Apart from SPL, the results showed significant improvement in all vocal parameters for the subject with the paralyzed vocal fold in the paramedian position, but not for the subject with the paralyzed vocal fold in the median position. Both subjects demonstrated the activation of the cricothyroid muscles with the NMES application. They also reported no negative symptoms in the larynx or the presence of delayed onset muscle soreness postintervention.
Conclusions: The results of this study support the use of NMES as an effective method for the treatment of UVFP in the paramedian position.
Summary Introduction: Enhanced contact endoscopy (ECE) – combination of contact endoscopy and NBI (narrow-band imaging) or IMAGE1 S, is a noninvasive optical technique used for assessment of superfi ...cial vascular changes of mucosal lesions in high magnifi cation. Aim: The aim of our study was to evaluate the dia gnostic value of ECE in an intraoperative settlement and validation of the ELS classifi cation. Methods: Patients with laryngeal lesions underwent direct laryngoscopy with a structured assessment of the lesion using white light, NBI and ECE. Lesions were classified according to the European Laryngological Society Classifi cation that divides the vascular pattern changes into longitudinal (unsuspicious) and perpendicular (suspicious). Evaluation was correlated with histopathology. Results: 60 patients with 76 lesions were enrolled. Sensitivity, specifi city, positive predictive value (PPV), negative predictive value (NPV) and accuracy for NBI assessment reached 71.4%, 100%, 100%, 53.8% and 78.6%, resp., index of 0.556. Sensitivity, specifi city, PPV, NPV and accuracy for ECE reached 86.4%, 89.5%, 95.0%, 73.9% and 87.3%, index of 0.716. Additional 20% (9/ 45) of the leukoplakias could be assessed with ECE compared to NBI. Conclusions: Our data support the assumption that ECE is a useful tool for pre-histological examination of mucosal lesions, however it cannot fully replace bio psy sampling. ECE shows higher accuracy in detecting malignant lesions compared to NBI and can be especially helpful in the assessment of vocal fold leukoplakia. Key words enhanced contact endoscopy – narrow-band imaging – laryngeal mucosal lesions – squamous cell carcinoma – leukoplakia
Background: This study focuses on the hearing threshold for bone conduction (BC) after middle-ear surgery. Methods: A total of 92 patients (120 ears) were treated for newly diagnosed chronic otitis ...media with cholesteatoma (2013−2018). BC was examined at frequencies of 0.5, 1, 2, and 4 kHz prior to and 1 year after surgery. STAM classification for cholesteatoma location, EAONO/JOS for stage, and surgery according to SAMEO-ATO classification were applied. The bone conduction threshold was compared for individual frequencies in patients with occurrence/absence of cholesteatoma in different locations. Results: For the occurrence of cholesteatoma in the attic (A), a statistically significant difference was found at 4 kHz (p < 0.001), in the supratubal recess (S1) at 4 kHz (p = 0.003), and for the mastoid (M) at 0.5 kHz (p = 0.024), at 1 kHz (p = 0.032), and at 2 kHz (p = 0.039). Conclusions: Cholesteatoma location can influence the post-operative hearing threshold for bone conduction.
Purpose
Taste perception is often affected after stapes surgery despite effort to preserve chorda tympani nerve. The aim was to examine changes of particular taste qualities and their recovery after ...operation of otosclerosis.
Materials and methods
Taste function was prospectively investigated with a questionnaire and a taste strip test (TST) preoperatively, 3–5 days and 1 year after stapes surgery with the preservation of CTN.
Results
In the early postoperative examination, 34/42 patients had a lower TST score, 7/42 decrease of taste in the questionnaire. One year after surgery, 11/42 patients had a lower TST score, 1/42 patients decrease of taste in the questionnaire. The most pronounced decrease in the TST score was in sweet (− 1.76 points,
p
< 0.001), followed by bitter (− 1.71 points,
p
< 0.001), salty (− 1.64 points,
p
< 0.001) and sour taste (− 1.33 points,
p
< 0.001). The sour taste had a significant lower alteration compared to others. Men had significantly pronounced alteration in salty taste compared to women. The complete recovery was proved in bitter taste. Better recovery in bitter taste was observed in patients younger than 45 years of age.
Conclusions
Gustatory changes after stapes surgery are mostly transient with different impairment and recovery rate for particular taste qualities. A sour taste seems to be relatively resistant to damage. The best recovery rate is in a bitter taste, especially in younger patients.
Pseudogout is characterized by the deposition of calcium pyrophosphate dihydrate crystals (CPPD), primarily affecting large joints. Extra‐articular manifestations, particularly in the head and neck ...region, are exceedingly rare. We report a unique case of bilateral isolated pseudogout of the middle ear manifesting with progressive conductive hearing loss as the first and only symptom of pseudogout. Otoscopy and CT scan often yield a differential diagnosis that includes tumors or cholesteatoma, necessitating surgery with histopathological examination. The definitive diagnosis is confirmed upon identification of calcium pyrophosphate dihydrate crystals. In most cases, removal of the crystals results in resolution of conductive hearing loss. Laryngoscope , 2024
The present study aims to evaluate the reliability and construct validity of the Czech version of the Voice Handicap Index (VHI-CZ) and determine the cut-off value to distinguish dysphonic patients ...from nondysphonic individuals.
Prospective study, Parallel group design.
The study investigated 100 adult patients with dysphonia, divided into three groups based on the etiology of the voice problem (neurogenic, functional, and structural). Out of these, 25 patients were used for test-retest analysis, and 45 patients to determine the responsiveness to change. The control group consisted of 51 healthy subjects. All 151 individuals completed the VHI-CZ and were examined with the videolaryngostroboscopy. The internal consistency (Cronbach’s alpha), the test-retest reliability (Intra-class Correlation Coefficient, ICC), and the construct validity were analyzed and the normative cut-off value was determined.
The internal consistency of the VHI-CZ was excellent (Cronbach α = 0.984), and test-retest reliability was also excellent (ICC = 0.95, P < 0.001). The correlation between the self-assessed severity of the voice disorder and the VHI-CZ score was strong (Spearman's ρ = 0.877, P < 0.001). The VHI scores differences between dysphonic and nondysphonic patients were statistically significant (Mann-Whitney U test, P < 0.001). The differences among the three etiological subgroups (neurogenic, functional, and structural) were also statistically significant (Kruskal-Wallis test, P < 0.001). Moreover, the differences in the VHI-CZ total scores between pretreatment and posttreatment were statistically significant (Wilcoxon test, P < 0.001). The cut-off score of 13 points was found, by the analysis of the Receiver Operating Characteristic (ROC, Youden Index), to be most suitable for preselecting dysphonic individuals.
The existing VHI-CZ showed excellent reliability and construct validity. The Czech VHI is a useful and valid monitoring tool for clinicians.
Unilateral vocal fold palsy independently of etiology results in glottic insufficiency leading to unfavorable short or long-term impact on voice quality. Our aim was to evaluate the effect of ...injection laryngoplasty using Radiesse® Voice and thyroplasty type I on glottic closure, voice quality and aerodynamics by comparing preoperative, short- and long-term results.
Data of 32 consent patients were reviewed between 2012 and 2023. All patients underwent either injection laryngoplasty (14 patients) or thyroplasty type I (18 patients) under local anesthesia. Maximum phonation time, glottic closure based on videolaryngostroboscopy, VHI-30 values and GRBAS scale were recorded prior, short-term (3 month) and long-term (12 months) after procedures for statistical comparison. Friedman test, Mann-Whitney test and Wilcoxon signed rank tests were used for statistical analysis.
In injection laryngoplasty group, we found significant improvement in maximum phonation time (p = 0.002), grade of hoarseness (p = 0.002) and breathiness (p = 0.000) when comparing results before and short-term after procedure. In thyroplasty type I group we saw significant improvement of maximum phonation time (p = 0.000), glottic insufficiency (p = 0.000), all three VHI-30 components (p = 0.000), as well as grade of hoarseness, breathiness (both p = 0.000) and roughness (p = 0.011) of GRBAS scale when comparing voice outcome before and short-term after procedure. There was no significant difference in voice outcome results neither between short and long-term results nor between the two groups in any parameter.
These results demonstrate both short and long-term efficiency of injection laryngoplasty and thyroplasty type I in the improvement of voice quality and glottic closure.
