Sociodemographic variables of a german sample of patients with contact granuloma

We report 28 German patients with contact granuloma (27 male, 1 female). Their mean age was 52 years (ranging from 35 to 70). Thirty-two percent were retired. The occupations of the others represented a wide range of different jobs. The majority of the sample had a middle educational level. Most patients lived with their family or with a partner. According to self-assessments, 68% had average daily strain on their speaking voice. All patients were nonsmokers. The patients felt themselves more disturbed by somatic troubles as the general population. Heartburn was felt by nearly half of the patients. A little more than half of the patients suffered from globus sensation. Thus, it is not possible at present to explain the laryngeal contact granuloma by sociodemographic data, vocal stress, or special somatic complaints in this sample. Therefore a multifactorial etiology should be supposed.     

Nonspecific laryngeal granuloma: A case study of a professional singer

A professional singer with laryngeal granuloma underwent surgery following failed response to conservative treatments. Two primary findings emerged. First, although a sizable lesion was present initially, presurgical voice measures were largely normal or superior. The exception was elevated phonatory effort during singing. Second, postsurgical voice functions were entirely normal or superior (including phonatory effort), despite demanding singing performances a few weeks following surgery. The results add to the limited corpus of quantitative, normative-referenced data on voice in patients with granulomas and are inconsistent with previous reports of voice abnormalities in such patients and poor functional response to surgery.     

The debate on the dependence of apparent contact angles on drop contact area or three-phase contact line: A review

A sessile drop is an isolated drop which has been deposited on a solid substrate where the wetted area is limited by the three-phase contact line and characterized by contact angle, contact radius and drop height. Although, wetting has been studied using contact angles of drops on solids for more than 200 years, the question remains unanswered: Is wetting of a rough and chemically heterogeneous surface controlled by the interactions within the solid/liquid contact area beneath the droplet or only at the three-phase contact line? After the publications of Pease in 1945, Extrand in 1997, 2003 and Gao and McCarthy in 2007 and 2009, it was proposed that advancing, receding contact angles, and contact angle hysteresis of rough and chemically heterogeneous surfaces are determined by interactions of the liquid and the solid at the three-phase contact line alone and the interfacial area within the contact perimeter is irrelevant. As a consequence of this statement, the well-known Wenzel (1934) and Cassie (1945) equations which were derived using the contact area approach are proposed to be invalid and should be abandoned. A hot debate started in the field of surface science after 2007, between the three-phase contact line and interfacial contact area approach defenders. This paper presents a review of the published articles on contact angles and summarizes the views of the both sides. After presenting a brief history of the contact angles and their measurement methods, we discussed the basic contact angle theory and applications of contact angles on the characterization of flat, rough and micropatterned superhydrophobic surfaces. The weak and strong sides of both three-phase contact line and contact area approaches were discussed in detail and some practical conclusions were drawn.     

Distortions of videofiberoscopy imaging: Reconsideration and correction

An analysis was made of the optical distortion of a lens system of a fiberscope and the distortion related to lens-object angles and lens-object distances used in laryngeal flexible endoscopic examinations. The optical distortion was systematic and, therefore, could be corrected through computer processing once the calibration was made. Similarly, the distortion related to the lens-object angle and distance varied systematically depending on distance and angle and, therefore, could be predicted if those parameters were measured simultaneously. The correction of those distortions of videofiberoscopic image is demonstrated, and a procedure for recording and measuring laryngeal images that minimizes measurement error due to those distortions is suggested.     

Treatment of spasmodic dysphonia (laryngeal dystonia) with local injections of Botulinum toxin

In 1984 the authors performed the first laryngeal injection of Botulinum toxin for laryngeal dystonia via percutaneous, electromyographically guided technique. Since that time we have treated 450 patients with adductor spasmodic dysphonia, abductor spasmodic dysphonia, and adductor breathing dystonia. In general, the adductor patients received bilateral injections of 1.25 U to 3.75 U, obtaining greater than 90% of normal voice. The abductor patients received unilateral or staged bilateral injections of the posterior cricoarytenoid muscles with 0.6 to 3.75 U, obtaining 70% of normal function. We have found laryngeal injections of Botulinum toxin to be safe and effective therapy for the symptoms of laryngeal dystonia (spasmodic dysphonia).     

Arytenoid Cartilage Dislocation: A 20-year Experience

SUMMARY: Arytenoid cartilage dislocation is an infrequently diagnosed cause of vocal fold immobility. Seventy-four cases have been reported in the literature to date. Intubation is the most common origin, followed by external laryngeal trauma. Decreased volume and breathiness are the most common presenting symptoms. We report on 63 patients with arytenoid cartilage dislocation treated by the senior author (RTS) since 1983. Significantly more posterior than anterior dislocations were represented. Although reestablishing joint mobility is difficult, endoscopic reduction should be considered to align the heights of the vocal processes. This process may result in significant voice improvement even long after the dislocation. Strobovideolaryngoscopy, laryngeal electromyography, and laryngeal computed tomography (CT) imaging are helpful in the evaluation of patients with vocal fold immobility to help distinguish arytenoid cartilage dislocation from vocal fold paralysis. Familiarity with signs and symptoms of arytenoid cartilage dislocation and current treatment techniques improves the chances for optimal therapeutic results.     

An investigation of the laryngeal system as the resonance source of the singer''s formant

Since its introduction, the Sundberg model of the laryngeal system as the resonance source of the singer's formant has gained wide acceptance. However, no studies directly testing this hypothesis in vivo have previously been reported. Thus, the present study was undertaken to test this hypothesis on three classically trained professional male singers. The vocal behaviors of the singer-subjects were evaluated during modal and pulse register phonation via magnetic resonance imaging, strobolaryngoscopy, and acoustic analysis. Results indicated the subjects did not achieve the laryngopharyngeal/laryngeal outlet cross-sectional area ratio requisite to the model and that the formant remained robust in pulse register phonation. It was concluded that these subjects' behaviors were not consistent with Sundberg's model and that the model was inadequate to account for the generation of the singer's formant in these three subjects.     

Hyaluronic Acid: Its Role in Voice

The extracellular matrix (ECM), once regarded simply as a structural scaffold, is now recognized as an important modulator of cellular behavior and function. One component that plays a prominent role in this process is hyaluronic acid (HA)--a molecule found in many different tissues. Research into the roles of HA indicates that it plays a key role in tissue viscosity, shock absorption, and space filling. Specifically, research into the role of HA in laryngology indicates that it has profound effects on the structure and viscosity of vocal folds. This article provides an introduction to the structure and biological functions of HA and its importance in voice. In addition, an overview of the pharmaceutical applications of HA is discussed.     

Voice characteristics, effects of voice therapy, and long-term follow-up of contact granuloma patients

This study evaluates the laryngoscopic findings and voice characteristics of male contact granuloma patients before and after voice therapy and at a follow-up about 9 years later. Pre- and posttherapy recordings as well as follow-up recordings were made for 19 granuloma patients. Pretherapy revealed the most salient perceptual voice characteristics were low pitch, monotony, and a high degree of vocal fry and hyperfunction. Interjudge reliability for these traits was high. Immediately following therapy the healed patients (n = 10) had a decrease in hyperfunction, vocal fry, and monotony, while the unhealed patients (n = 9) had an increase in hyperfunction and vocal fry decreased only marginally. Monotony decreased significantly in this group. As regards the acoustic analyses, no significant differences were found in mean fundamental frequency (F₀) or perturbation. At the follow-up assessment 4 patients had granuloma while 15 had normal laryngeal status. Perceptually their voice characteristics resembled those pretherapy independently of the laryngeal findings. The results suggest that reduced hyperfunction and decreased vocal fry may create better circumstances for the healing process at the posterior glottis.     

一种用于界面接触状态评价的超声信号相似度分析方法*

针对常规超声反射系数对界面接触状态灵敏度受限问题,论文发展一种用于界面接触状态评价的超声信号相似度分析方法。针对不同压力下承压界面超声检测信号,研究了激励信号带宽、相似度函数类型及分析域对相似度分析方法对界面接触状态评价的影响。结果表明,检测信号的相似度指标随压力增加呈现明显规律性。激励信号带宽、相似度函数类型和分析域对界面接触状态评价效果有很大的影响。宽带激励下的时域欧式距离指标对界面压力微变化最为敏感,可用于界面接触状态的定量评价。     

A study of contact interface and wear diagnosis for hand taps using ultrasonic method

This work was to study the contact interface between a set of used hand taps and another new one based on the regional scanning of ultrasound. The contact image was a novel disclosure for hand taps contact. The objective of this work was to provide a wear diagnosis by making a comparison of contact area between the used and the new hand taps. The 2D maps showed an apparent change not only in area sizes but also in contact shapes between the used and the new hand taps. The 3D contact images also provided useful information to show the degree of contact.The contact area between the tap and the workpiece was calculated using an image analysis software package. The range of contact areas varied from 2.49 mm² to 35.31 mm² for the used hand taps and from 1.19 mm² to 28.55 mm² for the new taps, depending on the definition of the contrast ratio. The result provided another scientific data for users to decide a correct timing for the tool replacement. In addition, maps of reflection coefficient and pressure contour distribution were presented. The range of contact pressure varied from 2.5 Mpa to 4.2 Mpa.     

How I Do It: Miniplate Reconstruction of the Lateral Thyroid Lamina: One-Stage Restoration of Voice After Teflon Granuloma Resection

This case report describes a one-stage technique for long-term voice restoration and laryngeal reconstruction in the treatment of Teflon (Dupont, Wilmington, Delaware) granuloma. A patient who presented with severe dysphonia underwent resection of a Teflon granuloma via a lateral laryngotomy. A pedicled strap muscle flap was used to reconstruct the paraglottic space. The muscle flap was positioned through the lateral laryngotomy with direct endoscopic visualization of the endolarynx to ensure correct vertical positioning and medialization of the vocal fold. The muscle flap was secured in this position with suture fixation. The trapdoor piece of cartilage that was elevated to create the window in the lateral thyroid lamina was repositioned over the pedicled muscle flap and reinforced with a titanium miniplate, which was secured to the remaining thyroid cartilage. The patient had excellent voice results and has not required revision or augmentation. Reinforcement of the lateral thyroid lamina using titanium miniplate fixation helps to stabilize the muscle pedicle flap and the position of the vocal fold, in this case resulting in good long-term voice results after a single-stage reconstruction.     

Mild Vocal Fold Paresis: Understanding Clinical Presentation and Electromyographic Findings

The implications of mild vocal fold hypomobility are incompletely understood. This study describes the clinical, electromyographic, and probable etiologic findings in patients who presented with complaints of dysphonia and whose physical examination revealed vocal fold paresis as a factor possibly contributing to their voice complaints. A retrospective chart review of all patients who presented to a tertiary laryngology referral center over a 13-month period, who had a clinical diagnosis of mild vocal fold hypomobility and who underwent laryngeal electromyography, were included in the study. A total of 22 patients completed the medical evaluation of their voice complaint. Of these patients, 19 (86.4%) were found to have evidence of neuropathy on laryngeal electromyography. The clinical picture indicated the following probable origins for the vocal fold paresis: goiter/thyroiditis (7/22 or 31.8%), idiopathic (4/22 or 18.2%), viral neuritis (4/22 or 18.2%), trauma (3/22 or 13.6%), and Lyme's disease (1/22 or 4.5%). This article describes the clinical entity of mild vocal fold hypomobility and associated flexible laryngoscopic, rigid strobovideolaryngoscopic, and laryngeal electromyographic findings.