The Inspiratory Maneuver: A Simple Method to Assess the Superficial Lamina Propria During Endoscopy

We describe a simple means of assessing the condition of the superficial lamina propria during endoscopy, which we use in our practice as an adjunct to careful stroboscopic examination. An intake of breath against partially adducted vocal folds serves to draw the mucosa inferomedially into the glottis, which reveals areas of diminished mobility, the relationship of mucosal lesions to deeper tissues of the vocal folds, and subtle submucosal lesions. This is possible because of the unique geometry of the glottis that renders the vector forces of airflow different at inspiration and expiration. Because the integrity of the superficial lamina propria is essential to healthy phonation, we have found the inspiratory maneuver useful across a wide variety of mucosal pathologic conditions.     

Experiment and prediction of a cavity type separated flow

A detail study involving flow visualization, Laser Doppler Velocimeter (LDV) measurements and numerical prediction is presented. The visualization experiments revealed striking results of a pulsatile motion in the separated flow region associated with the formation and passage of large eddy structures. Measurements of mean velocities and turbulence intensity profiles across the separated flow field, provided information about the separated shear layer development and the recirculating flow pattern. The numerical predictions, obtained with a two-layer turbulence model in conjunction with the SIMPLE algorithm, failed to reproduce the coherent eddies and the pulsatile motion, but the mean velocities are reasonably reproduced.     

Laryngeal Chondroma

Cartilaginous tumors of the larynx represent less than 1% of laryngeal tumors. Chondroma and "low-grade" chondrosarcoma are the most common; 70%-75% of these tumors arise on the endolaryngeal surface of the posterior lamina of the cricoid cartilage. The clinical presentation is varied and directly dependent on the size and location of the tumor; stridor, hoarseness, dyspnea, or a neck mass are common presenting signs. CT scanning in the axial plane is the mainstay of radiographic imaging due to its ability to show size, extent of the tumor, and invasion into surrounding structures. Surgical extirpation is the standard therapy with no role for radiation therapy or chemotherapy. Although significant recurrence rates have been reported, there is not a significant difference between initial conservative therapy followed by salvage therapy versus initial radical therapy.     

Characterization of chronic vocal fold scarring in a rabbit model

The purpose of the current study was to assess the histologic and rheologic properties of the scarred vocal fold lamina propria during a chronic phase of wound repair in a rabbit model. Eighteen rabbit larynges were scarred using a procedure that involved stripping the vocal fold lamina propria down to the thyroarytenoid muscle, using 3-mm microforceps. The approximate dimension of injury to the vocal fold was 3 x 1.5 x 0.5 mm [length x width x depth]. At 6 months postoperatively, histologic analysis of the scarred and control lamina propria in eight of these rabbits was completed for collagen, procollagen, elastin, and hyaluronic acid. Compared with control samples, scarred tissue samples revealed fragmented and disorganized elastin fibers. Additionally, collagen was significantly increased, organized, and formed thick bundles in the scarred vocal fold lamina propria. Measurements of the viscoelastic shear properties of the scarred and control lamina propria in the remaining 10 rabbits revealed increased elastic shear modulus (G') in 8 of 10 scarred samples and increased dynamic viscosity (eta') in 9 of 10 scarred samples. Although rheologic differences were not statistically significant, they revealed that on average, scarred samples were stiffer and more viscous than the normal controls. Histologic data are interpreted as indicating that by 6 months postinjury, the scarred rabbit vocal fold has reached a mature phase of wound repair, characterized by an increased, organized, and thick bundle collagen matrix. Rheologic data are interpreted as providing support for the potential role of increased, thick bundle collagen, and a disorganized elastin network on shear stiffness and dynamic viscosity in the chronic vocal fold scar. Based on these results, a 6-month postoperative time frame is proposed for future studies of chronic vocal fold scarring using the rabbit animal model.     

Prolonged Ulcerative Laryngitis

Acute and prolonged laryngitis commonly are diagnosed and treated by primary care physicians. These ailments come to the attention of the otolaryngologist when symptoms are prolonged despite treatment. Since the beginning of 1991, the senior authors (RTS, JRS) have recognized a clinical syndrome defined by prolonged hoarseness, prolonged laryngeal inflammation, and vocal fold ulceration. Patients are frequently young, nonsmokers, and nondrinkers who have had an upper respiratory infection prior to, or associated with, the onset of laryngeal symptomatology. Patients may be affected for up to 1 year despite aggressive medical therapy. This review of 14 patients highlights the features of this previously undescribed entity.     

Sectionally Semicomplemented Distributive Nearlattices

A nearlattice S is a meet semilattice together with the property that any two elements possessing a common upper bound have a supremum. Here the authors have introduced the notion of sectionally semicomplemented distributive nearlattices and given several characterizations of them. The skeleton SCon(S) of Con(S), the congruence lattice, consists of all those nearlattice congruences which are the pseudocomplements of members of Con(S). The relationship between skeletal congruences and kernel of skeletal congruences leads to numerous characterizations of sectionally semicomplemented distributive nearlattices and semiboolean algebras. For example we prove, for a distributive nearlattice S with 0, the following conditions are equivalent: