There is no normative voice dataset for Japanese speakers in the English literature. We constructed age- and gender-stratified normative voice data with the assistance of vocally healthy Japanese ...speakers.
A total of 111 vocally healthy Japanese speakers (42 men, 69 women) were divided into young (13 men, 30 women), middle-aged (18 men, 27 women), and elderly (11 men, 12 women) groups. Participants underwent aerodynamic, acoustic, and audio-perceptual studies of sustained habitual vowel phonations, and the obtained data were statistically analyzed in terms of age and gender.
Both gender- and age-related differences were noted in fundamental frequencies, sound pressure level, shimmer, and amplitude perturbation quotient, while only gender-related differences were noted in mean flow rate and only age-related changes were observed in subglottal pressure; laryngeal resistance; and G, R, B, and S scores of the GRBAS scale. The gender- and age-related difference data were comparable with the reported data in other languages, ethnicities, or countries.
The present study is the first to provide a database of normative voice data of Japanese speakers. The idiosyncrasy of Japanese is considered minor in sustained habitual vowel phonations.
Little is known about the normal variations in vocal fold vibrations. We conducted a prospective study on normal subjects using high-speed digital imaging (HSDI) to elucidate key parameters regarding ...age/gender-related normal variations.
Forty-six healthy adult volunteers were divided into young (aged ≤35 years) male, young female, elderly (aged ≥65 years) male, and elderly female subgroups. HSDI data of sustained phonation of /i/ at a comfortable pitch and loudness were obtained, and vibratory parameters were calculated using the visual-perceptual rating, laryngotopography, digital kymography, and glottal area waveform. Multivariate analysis was then performed on these parameters to clarify the subgroup-specific key parameters.
Four key parameters were identified from a total of 83: one from visual perceptual rating and three from laryngotopography. Subgroup analyses showed that posterior-to-anterior longitudinal phase difference (PD) and high fundamental frequency (F
) were specific to young female participants. A low F
was specific to young male participants. Large anterior-to-posterior longitudinal PD and its left-right difference were specific to elderly male participants. There were no key parameters for elderly female participants.
Methods that can assess F
and longitudinal PD, such as visual-perceptual rating and laryngotopography, were effective in the evaluation of normal vocal fold vibrations and their variations.
One of the intraoperative complications of tracheostomy under general anesthesia is cuff injury of the intubation tube. In the present study, we investigated whether a blunt tracheal opening is a ...useful method to avoid cuff injury. A retrospective cohort study was conducted to examine patients who underwent tracheostomy under general anesthesia at a single institution from January 1, 2017 to July 31, 2021. Electrocautery was used to thin the connective tissue between the tracheal rings, and bluntly open the trachea with mosquito forceps or similar instruments. Primary outcomes included cuff injury rate, number of surgeons involved, and career as otolaryngologist at the time of surgery. The secondary outcome was perioperative complications. Of the 64 cases, 3 had cuff injuries. 2 of the 3 had cuff injuries during the creation of an anteriorly based flap. 16 surgeons were involved ranging from the first to sixth year as an otolaryngologist, with the third year of otolaryngologist being the most common. The median physician year for instructors was 18 years. The most common postoperative complication was granulation in 9 cases. There were no cases of incorrect cannula insertion or difficulty in cannula insertion. A blunt tracheal opening was considered useful as a method to prevent cuff injury.
Fusobacterium necrophorum has recently been suggested to be associated with tonsillopharyngitis, peritonsillar abscess, and recurrent tonsillitis. Between the 2 subspecies of F. necrophorum, subsp. ...funduliforme is known to be a major human pathogen. To better understand the epidemiology of F. necrophorum subsp. funduliforme (FNSF), we studied the prevalence of FNSF in the tonsils of patients undergoing elective tonsillectomy (TE) for different indications. Adult patients who underwent elective TE from October 2014 to November 2015 were included. The tonsils were sent for aerobic and anaerobic tissue culture within 30 min of excision; the presence of FNSF was detected using PCR with gyrB primers and 16S rRNA. A total of 32 patients were enrolled. The prevalence of FNSF identified by either culture or gyrB PCR did not significantly differ between infectious and noninfectious TE indications. The constant presence of FNSF might not be associated with recurrent pharyngotonsillitis.
There is no normative voice dataset regarding the vocal capacity of Japanese speakers in the English literature. We collected age- and sex-stratified data on the vocal capacity of vocally healthy ...Japanese speakers.
In total, 111 vocally healthy Japanese speakers (42 men and 69 women) were divided into the young (13 men and 30 women), middle-aged (18 men and 27 women), and elderly (11 men and 12 women) groups. Participants underwent duration-, intensity-, and pitch-related vocal capacity tests using either a conventional method or an aerodynamic method or both. The data obtained were statistically analyzed in terms of age and sex.
Overall, the duration- and pitch-related parameters measured by the conventional method were generally comparable to the previous results in the literature, while duration-, pitch-, and intensity-related parameters measured by the aerodynamic method differed significantly from them. Significant sex differences were noted in all parameters in the duration-, intensity-, and pitch-related vocal capacity tests. Furthermore, significant age-related changes were observed in all parameters, except for the mean flow rate and highest pitch measured by the aerodynamic method.
This study is the first to provide a sex- and age-stratified database of the normative vocal capacity data of Japanese speakers. However, further improvements will be needed in the assessment protocols, conditions, or devices used for the duration-, intensity-, and pitch-related vocal capacity tests in the aerodynamic method.
Summary Objective To quantify vibratory characteristics of various laryngeal disorders seen by high-speed digital imaging (HSDI). Methods HSDI was performed on 78 patients with various laryngeal ...disorders (20 with polyp, 16 with carcinoma, 13 with leukoplakia, 6 with vocal fold nodule, and 33 with others) and 29 vocally healthy subjects. Obtained data were quantitatively evaluated by frame-by-frame analysis, laryngotopography, digital kymography, and glottal area waveform. Results Overall, patients with laryngeal pathologies showed greater asymmetry in amplitude, mucosal wave and phase, smaller mucosal wave, and poorer glottal closure than vocally healthy subjects. Furthermore, disease-specific vibratory disturbances that generally agreed with the findings in the literature were quantified: comparing polyp with nodule, differences were noted in longitudinal phase difference, amplitude, and mucosal wave. In comparison with leukoplakia and cancer, nonvibrating area was more frequently noted in cancer. Conclusions The HSDI analysis of various voice disorders using multiple methods can help phonosurgeons to properly diagnose various laryngeal pathologies and to estimate the degree of their vocal disturbances.
A 42-year-old man diagnosed with acute myeloid leukemia complained of progressive swelling of the right side of his face with pain 11 days after the third cycle of consolidation therapy with ...high-dose arabinosylcytosine-cytarabine. Head and neck magnetic resonance imaging showed a mass lesion in his right maxillary sinus with parapharyngeal involvement, which included the right masseter muscle, intraorbital involvement, and an abscess in his brain. Chest computed tomography revealed peribronchial small nodules in his right upper lobe and a necrotic tumor in his right lower lobe. Molds identified as
Cunninghamella bertholletiae
were isolated from the necrotic ulcer. According to these results, chemotherapy for leukemia was discontinued. High-dose liposomal amphotericin (10 mg/kg/day) was initiated. Because renal dysfunction occurred, the dosage was decreased to 6 mg/kg and combined with 150 mg/day micafungin. Debridement of necrotic tissue in the right maxillary sinus and establishment of the fenestration between the sinus and oral cavity were performed. Subsequently, brain and lung lesions were surgically removed. Rhinocerebral mucormycosis was successfully treated without relapse over 3 years by a 112-day course of intravenous anti-fungal therapy and 223-day course of terbinafine and partial surgical removal, respectively, to maintain masticatory and ocular functions. To our knowledge, there has been no other report of a long-term survival case of rhinocerebral mucormycosis due to
C. bertholletiae
.
Although many quantitative parameters have been devised to describe abnormalities in vocal fold vibration, little is known about the priority of these parameters. We conducted a prospective study ...using high-speed digital imaging to elucidate disease-specific key parameters (KPs) to characterize the vocal fold vibrations of individual voice disorders. From 304 patients with various voice disorders and 46 normal speakers, high-speed digital imaging of a sustained phonation at a comfortable pitch and loudness was recorded and parameters from visual-perceptual rating, laryngotopography, digital kymography, and glottal area waveform were calculated. Multivariate analysis was then applied to these parameters to elucidate the KPs to explain each voice disorder in comparison to normal subjects. Four key parameters were statistically significant for all laryngeal diseases. However, the coefficient of determination (R2) was very low (0.29). Vocal fold paralysis (8 KPs, R2 = 0.76), sulcus vocalis (4 KPs, R2 = 0.74), vocal fold scarring (1 KP, R2 = 0.68), vocal fold atrophy (6 KPs, R2 = 0.53), and laryngeal cancer (1 KP, R2 = 0.52) showed moderate-to-high R2 values. The results identified different KPs for each voice disorder; thus, disease-specific analysis is a reasonable approach.
Summary Introduction Kymography is an effective method for assessing temporal patterns of vocal fold vibrations. Because kymographic data for a number of normal speakers based on high-speed digital ...imaging (HSDI) were limited in the literature, this prospective study was conducted to provide normative kymographic HSDI data and clarify gender- and age-related normal variations. Methods Vocally healthy adults were divided into young (≤35 years) and elderly groups (≥65 years). Kymograms were recomposed from HSDI data at the midglottal level, and kymographic parameters were analyzed quantitatively. Then gender- and age-related differences were evaluated. Results A total of 26 young subjects (9 men and 17 women, mean age: 27 years) and 20 elderly subjects (8 men and 12 women, mean age: 73 years) were investigated. Obtained data generally matched the values in the literature. Slight asymmetry was seen in all groups, with the elderly subjects having more evident asymmetry than the young subjects. Most of the kymographic parameters showed a negative correlation with fundamental frequency (F0 ), whereas the open quotient displayed a positive correlation with F0 . There were significant intergroup differences in F0 , amplitude and lateral peak at a speaking F0. Conclusions The present quantitative findings generally matched the qualitative kymographic data reported in the literature. When judging whether a vibratory pattern is normal or pathological, both gender and age should be taken into account, because gender- and age-related variations of symmetry, F0 , and phase were frequently observed in the present study.
Abstract Objective It is important to assess the causes of vocal fold paralysis. Many studies have reported causes of paralysis, but few reports have shown changes in longitudinal etiology in a ...single institution. Methods We investigated the medical records of 797 patients with vocal fold paralysis from 1990 to 2005 at the voice and bronchoesophageal outpatient clinics at the University of Tokyo Hospital. We evaluated the etiology of paralysis, and compared our results with a previous study by Hirose in our clinic from 1961 to 1989 to assess changes in etiology. Results The postoperative group comprised 466 patients (58.5%), while the non-surgical group comprised 331 (41.5%) patients. In the postoperative group, the most common cause of paralysis was thyroid surgery (106 cases), and other common causes were surgery for aortic aneurysm (61 cases) and tracheal intubation (58 cases). In the non-surgical group, idiopathic paralysis (134 cases) was the most common cause. Other common causes were lung cancer (34 cases) and cerebrovascular disease (24 cases). In a previous study from our clinic, the rate of postoperative paralysis was 43.5%. In the current analysis, the percentage of postoperative patients has increased remarkably compared with that of the previous report while the rate of idiopathic paralysis, has decreased by half. Conclusion The increase in postoperative cases of paralysis may be caused by the increasing frequency of operations for many diseases, due to the progress of medical techniques in recent years. The decrease in idiopathic cases may be related to the advances of diagnostic devices such as CT and MRI.
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