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1.
The flexible fiberoptic laryngoscope is a valuable tool in the examination of laryngeal and supraglottic structure and function. Nevertheless, persistent questions remain about the validity of the perceived image, and a variety of concerns arise relative to the equipment used, the difficult to examine patient, and the difficulty in obtaining measurable objective data. All of these areas are discussed. Distortions of the video image that result from the wideangle lens effect are described. Given an awareness of the distortions that may be present in the fiberoptic video image, it is clear that it is necessary to exercise caution in making judgments of anatomic or physiologic integrity based on fiberoptic information alone.  相似文献   

2.

Objective

To determine whether different modalities of laryngeal examination produce differences in the assessment of the posterior glottic chink (PGC), and whether the prevalence of PGC differs by gender.

Introduction

The PGC has been described as a triangular laryngeal space between the posterior laryngeal wall and the vocal processes during glottic closure found commonly in human females, but less often in males. The purpose of this study was not only to identify whether there are gender differences in prevalence of posterior glottic but also to determine whether there is a difference in detection of this configuration dependent on the modality of laryngeal imaging, specifically flexible nasopharyngolaryngoscopy (FNPL) versus rigid laryngoscopy (RL).

Methods

A review of 104 consecutive initial laryngeal examinations was performed. All patients underwent both flexible laryngoscopy (FL) and RL performed under stroboscopic light. Patients with immobile vocal folds, masses causing glottic gaps, atrophy, or severe muscle tension dysphonia causing an inability to fully visualize the entire length of the vocal fold were excluded. In the remaining patients, the posterior glottic configuration showing a posterior chink in relation to the vocal process was graded on a 0–4 scale (called the Posterior Glottic Closure Score [PGCS]); 0 was used to indicate a closed glottis and 4 the most open configuration without creating a complete glottic gap. PGCSs for males were compared with those of females, and the PGCSs obtained by flexible nasopharyngolaryngoscopy was compared with RL.

Results

Fifty-two patients were included in the study. Twenty-four of the patients were male, and 28 were female. The average age of the patients was 48.4 years (SD ± 17.35), and the range was 15–81 years. On RL, eight males had a PGCS 1–4, that is, evidence of PGC, and 23 females had a PGCS 1–4. On flexible nasopharyngolaryngoscopy, only four males had a PGCS 1–4 and 24 females had PGCS 1–4. Twenty-two females had a PGC detected by both modalities, and the PGCS was significantly higher using RL (2.73 ± 0.70 vs 2.14 ± 0.834) than FL. For the four males in which PGC was detected by both modalities, there was no statistical significance when comparing the PGCS between RL and FL (1.75 ± 0.96 vs 1.75 ± 0.5, P < 0.05). When comparing only males and females who had a PGC (PGCS 1–4), females had a higher PGCS (2.65 ± 0.78) than males (1.75 ± 0.71, P < 0.05) on RL, indicating a more open posterior glottis in females. On flexible examination, there was no difference detected in the average PGCS, 2.08 ± 0.83 for females and males 1.75 ± 0.50. PGCs were more common in younger (age 43 years) than older (age 54–56 years) subjects for both laryngoscopic modalities.

Conclusion

From this pilot study, we determined that there is a difference in male and female PGC prevalence and size. PGC is more common in females than males. Prevalence (or the detection rate) is about the same with RL and FL in females, but higher with RL than FL in males. The average score of the glottic opening, when present, was statistically significantly different between RL and FL in females but not in males. Furthermore, females had a larger PGCS on both modalities when compared with males, although this difference was only found to be statistically significant on RL; and complete glottic closure was more common in older than in younger subjects.  相似文献   

3.
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.  相似文献   

4.
The primary goal of this project was to develop a flexible transparent conductor with 100 Ω/sq and 90% transmittance in the wavelength range of 400-700 nm on a flexible substrate. The best result achieved so far was 110 Ω/sq at 88% transmittance using purified single-walled carbon nanotubes (SWNTs) coated on a polyethylene naphthalate (PEN) substrate. The secondary goal was to simplify the overall coating procedure; we successfully reduced the process from five (prior art method) to three steps utilizing a sonication method. We also found that the use of metallic SWNTs significantly improved the conductivity and transmittance compared with the use of mixed SWNTs, i.e., unseparated SWNTs. Furthermore, a possible adhesion mechanism between SWNTs and the surface of PEN was studied; we concluded that a π-π stacking effect and a hydrophobic interaction are the major contributing factors for SWNTs to adhere to the surface of the substrate.  相似文献   

5.
Superior laryngeal nerve paresis and paralysis   总被引:1,自引:0,他引:1  
Superior laryngeal nerve paresis and paralysis are relatively common but often difficult to diagnose with certainty. They are most commonly caused by viral infections, though other etiologies must be considered. A thorough history and physical examination, including strobovideolaryngoscopy and laryngeal electromyography, are needed for definitive diagnosis. It is essential to establish the diagnosis accurately to differentiate an apparent superior laryngeal nerve paresis from other conditions, such as myasthenia gravis. Laryngeal electromyography is used to confirm clinical impressions, as a guide for therapy, and as one measure of recovery. In our experience, accurate and early diagnosis assure the best phonatory outcome by directing therapy that will prevent or eliminate compensatory vocal abuses, which may themselves lead to even more serious vocal injury.  相似文献   

6.
We report a new type of black silicon: flexible black silicon. A silicon-on-insulator (SOI) wafer is irradiated by automatically scanning a femtosecond laser and then split by etching out the SOI silica middle layer. Large-area, uniform micro spikes on the surface of a very thin flexible silicon layer are obtained. The black silicon shows good flexibility and optical properties. The absorption spectrum of the flexible black silicon is as high as 97% in the visible and insensitive to the change of the incident angle of the light, which makes it a potential good candidate as an absorber for the solar-thermo generator.  相似文献   

7.
Electromyographic recordings of intrinsic laryngeal muscles were made during respiration, phonation, speech, and swallow in three subjects in two conditions: with and without intravenous administration of 5 mg of diazepam. The mean activity in microvolts of the thyroarytenoid and cricothyroid muscles was measured during respiration and the percentage increase over resting levels during inspiration, expiration, swallow, phonation, and speech. All subjects demonstrated significant (p ≤ 0.001) reductions in mean activity during respiration with diazepam. Significant (p ≤ 0.001) diazepam, subject, and subject by diazepam interactions were found in the percentage increase in muscle activation on each task. In one subject muscle activity consistently decreased, while in the other two subjects it consistently increased with diazepam. Although all had significant muscle relaxant effects, individuals differed in their diazepam responses during muscle activation. These differences may relate to a subject's age.  相似文献   

8.
This study investigated changes in maximum phonation time andacoustic and perceptual measures of voice following topical anesthesia and laryngeal endoscopy with the flexible endoscope. Forty-four females, aged 18–33 years and with normal voices, performed four vocal tasks: (a) 3-second /i/ prolongation, (b) maximum phonation time on /i/, (c) stepwise scale-singing, and (d) reading a standard passage. Subjects performed these tasks prior to anesthesia, after anesthesia, and again during laryngeal endoscopy. Voice samples were analyzed for jitter, shimmer, harmonic-to-noise ratio, speaking fundamental frequency, maximum phonational frequency range, maximum phonation time, harshness, and breathiness. Results demonstrated significant reductions in maximum phonational frequency range following anesthesia and, during laryngeal endoscopy, reductions in maximum phonation time and increases in speaking fundamental frequency, minimum fundamental frequency on scale-singing, and breathiness. Clinicians using laryngeal endoscopy for evaluation and management of vocal dysfunction should, therefore, consider the possible effects of these procedures on vocal functioning.  相似文献   

9.
The purpose of this study was to investigate the structure and function of larynges of 35 subjects with normal voices. Volunteers aged between 20 and 50 years with no history of voice disorders or laryngeal surgery, no current allergies, no formal voice training, and no hyperactive gag reflex were required to perform various vocal manoeuvres that were carried out under continuous and stroboscopic light. An assessment form was devised to record the condition and function of the larynx. The videotapes of the procedure were rated by experienced judges. The Australian Fiberscopic Profile was devised to record the relevant parameters under continuous light. Videostroboscopic ratings were carried out using the Bless (1) protocol rating. High interjudge agreement was found across the two rating profiles.  相似文献   

10.
A forming process called the mask and flexible pad laser shock forming was proposed to fabricate the micro-features on the copper foil. In this process, the mask and laser beam were used as rigid punches. Shock waves induced by plasma were used as the source of loading and plasticine was used as a flexible pad. This was a micro scale and high strain rate forming process and the traditional forming method with micro-mold was changed. In the experiment, surface morphology of formed parts was represented and it was found that the mask played a significant role in the forming process. In order to understand the forming process in the experiment, process parameters, including laser pulse energy, numbers of laser pulse and grain size, were analyzed. The experimental results showed that different parameters had different effects on formed parts. The surface quality and the thickness distribution of formed parts were investigated. It was found that formed parts could keep good surface quality after laser shocking and the reasons were explored. The thickness distribution was measured and the thickness thinning rate was calculated. There was no local tightening or rupture in the forming area. In this paper, the micro-features could be obtained on metallic foils and the method of mold-free was proved to be feasible.  相似文献   

11.
12.

Object

To evaluate the feasibility of an optimized MRI protocol based on high field imaging at 3 T in combination with accelerated data acquisition by parallel imaging for the analysis of oropharyngeal and laryngeal function.

Materials and Methods

Fast 2D gradient echo (GRE) MRI with different spatial resolutions (1.7×2.7 and 1.1×1.5 mm2) and image update rates (4 and 10 frames per second) was employed to assess pharyngeal movements and visualize swallowing via tracking of an oral contrast bolus (blueberry juice). In a study with 10 normal volunteers, image quality was semi-quantitatively graded by three independent observers with respect to the delineation of anatomical detail and depiction of oropharynx and larynx function. Additionally, the feasibility of the technique for the visualization of pathological pre- and post-surgical oropharynx and larynx function was evaluated in a patient with inspiratory stridor.

Results

Image grading demonstrated the feasibility of dynamic MRI for the assessment of normal oropharynx and larynx anatomy and function. Superior image quality (P<.05) was found for data acquisition with four frames per second and higher spatial resolution. In the patient, dynamic MRI detected pathological hypermobility of the epiglottis resulting in airway obstruction. Additional post-surgical MRI for one clinical case revealed morphological changes of the epiglottis and improved function, i.e., absence of airway obstruction and normal swallowing.

Conclusion

Results of the volunteer study demonstrated the feasibility of dynamic MRI at 3 T for the visualization of the oropharynx and larynx function during breathing, movements of the tongue and swallowing. Future studies are necessary to evaluate its clinical value compared to existing modalities based on endoscopy or radiographic techniques.  相似文献   

13.
The purpose of this retrospective study is to describe results of acoustic, aerodynamic, and videostroboscopic measures in patients complaining of laryngeal fatigue. Data were collected from 88 patients whose primary complaint was chronic laryngeal fatigue in the absence of visible laryngeal pathologies. The results revealed an abnormally high airflow rate and decreased maximum phonation time. An anterior glottal chink, anterior and posterior glottal chinks, or spindle-shaped glottal closure were found in 61% of the subjects.  相似文献   

14.
Behavior of the cricothyroid, lateral cricoarytenoid, vocalis, and interarytenoid muscles of William D. Vennard was electromyographically investigated. This article demonstrates electromyographic recordings that have not been published. Data presentation and discussion are focused on vocal registers, some phrases for voice training and warm-up, vowels, phonation modes, fundamental frequency control, the interarytenoid muscle, and some nonsinging behaviors  相似文献   

15.
The reasons for studying single flexible body dynamics are that on one hand, it is the basis of flexible multi-body dynamics. If the theory of the single flexible body dynamics has been deeply studied, the theory of flexible multi-body dynamics will be researched easily. On the other hand, it has its unique and important applications. Quasi-variational principle of non-conservative single flexible body dynamics is established under the cross-link of particle rigid body mechanics and deformable body mechanics. Taking the interceptor as an example, this paper has explained the physical meaning of the quasi-stationary value condition of the quasi-variational principle in non-conservative single flexible body dynamics. Taking the launch of rocket as an example, it has illustrated the features of “one force for two effects” in a single flexible body dynamics. With an example of the extending flexible beam coupled with the spacecraft attitude, it has shown the transition from the single flexible body dynamics to the flexible multi-body dynamics. Finally, a number of related problems are discussed. Supported by the National Natural Science Foundation of China (Grant No. 10272034), the Doctoral Education Foundation (Grant No. 20060217020), and the Natural Science Foundation of Harbin Engineering University (Grant No. HEUF04003)  相似文献   

16.
《Composite Interfaces》2013,20(3):247-258
In this study, a flexible interphase than matrix resin is studied. The fabrication method of unidirectional CFRP laminates with flexible fiber/matrix interphase has been established. The influence of the flexible interphase thickness on the flexural modulus and strength are experimentally investigated. The influence on the vibration properties are also investigated. It has been concluded that the flexible interphase with the optimized thickness could improve both the static and dynamic properties.  相似文献   

17.
Hermite cubic splines and collocation are used to solve, in an efficient and accurate way, the Chapman-Enskog equations for viscosity and heat transfer and to compute the Burnett functions required for Poiseuille-flow problems based on rigid-sphere collisions and the linearized Boltzmann equation.  相似文献   

18.
19.
Straightness, roundness, and primitive angle error of contour are important indicators of evaluating path precision during flexible material path processing. As processing path is composed of small arc or small line segment primitives, also the deformation of the flexible material during the processing path, making the captured image of processing path not clear, the edge of processing image over local uneven gray, the pixels of boundaries between the processing path image edge and background organizations not obvious. In order to extract the flexible material path contour effectively, mosaic method for flexible material processing path image is studied, next fast positioning strategy is introduced, and then we puts forward the search algorithm which taking processing path corner search as the cut-in-point, designing slope angle curve of starting and terminal point of each primitive and conducting slope angle curve for multiple scales wavelet transform by regarding DB(4) as wavelet operator based on wavelet edge modulus maxima extract principle. By judging whether one point of the curve appears at wavelet transform extremum, it can be determined whether the point is a corner one. In order to accelerate wavelet transform computing speed, FPGA IP core is 8-tap transpose is used to design the decomposition and reconfigurable of DB(4). The total time consumed by IP core wavelet decomposition increased only 2.802% compared to the PC computation time; path angle relative error is 8%, and the average measurement time is 198.22 ms.  相似文献   

20.
Direct measures of subglottal pressure obtained through a tracheal puncture were used to calculate laryngeal airway resistance. Six subjects completed tasks including syllable trains and more natural speech samples produced at three loudness levels. Direct calculations of natural speech resistance values were compared with indirect estimates obtained during syllable train production. The degree of correspondence between direct and indirect calculations varied by subject. Overall, the smallest relative errors among calculations occurred for syllable trains, with higher relative errors for the monologue and sentence. For loudness conditions, the smallest and largest relative errors occurred for soft and loud productions, respectively. The clinical utility of indirect estimation is questioned and suggestions for improving its validity are provided.  相似文献   

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