Two polypropionate metabolites from the cephalaspidean mollusk Philinopsis speciosa

Two polypropionate compounds, niuhinone-A and -B were isolated from a mollusk, $\text{Philinopsis speciosa}$, and their structures were elucidated by spectral methods.     

Use of flexible fiberoptic laryngoscopy to assess patients with spasmodic dysphonia

Flexible videolaryngoscopy was used to study 38 patients with spasmodic dysphonia, rating excessive activation of intrinsic laryngeal muscles, extrinsic muscle hyperfunction, tremor, and dystonic movements. Seventeen patients were also studied after unilateral botulinum toxin injection. Dysfunction varied greatly; however, discrete patterns could not be identified. Functional status correlated significantly with the total score of all pathologic indicators, but not with any single parameter. Botulinum toxin was highly effective in reducing intrinsic laryngeal muscle activation, but did not always improve tremor. Extrinsic laryngeal muscle hyperfunction was not significantly affected by the toxin     

Glottal configuration associated withfundamental frequency and vocal register

Simultaneous measurements of mean airflow rate, vocal intensityand fundamental frequency were made during flexible video endoscopic recording of the vowel /i/ sustained in two vocal registers, modal and falsetto. The glottal closure patterns of four males and four females were evaluated by visually inspecting the video images. Acoustic signals were recorded and analyzed to verify the frequency and intensity criteria. Aerodynamic analysis of mean airflow rate was done via Rothenberg mask and commercial software. Incomplete glottic closure was common in both males and females. The degree of closure was significantly higher for modal samples than for falsetto samples with frequency and intensity held constant. The shape of the glottal closure did not vary with changes in the mode of phonation. As expected, the mean airflow rate increased with decreased glottal closure. The results suggest that incomplete glottic closure should be considered as a normal glottal configuration in high frequency modal and falsetto phonation. Moreover, hourglass and spindle glottal configurations may also be found in both the modal and falsetto registers of normal subjects. These results also confirm the positive relationships between degree of glottal gap and mean airflow rate. Thus, mean airflow rate may be regarded as a criterion for judging degree of glottal closure.     

Botulinum toxin in the treatment of recalcitrant mutational dysphonia

Mutational falsetto is the failure of the normal drop in vocal pitch at puberty. Voice therapy almost always achieves an appropriate pitch; however, in cases of failure, surgical treatment has also been recommended. We report a case of a 47-year-old man with an above-average fundamental frequency and a thin voice quality in the absence of any signs of androgen insufficiency. Laryngeal examination revealed atrophy of the vocalis muscle. Voice therapy was unsuccessful in achieving a stable voice. Injection of 15 units of botulinum toxin into each cricothyroid muscle initially resulted in aphonia, but the voice returned by 1 week. Average fundamental frequency was 84 Hz at 1 week, 104 Hz at 1 month, and 100 Hz at 1 year. We hypothesize that mutational dysphonia is an habitual dysfunction of the voice with inappropriate activation of the cricothyroid muscle and disuse of laryngeal adductor muscles. Temporary deactivation of the cricothyroid muscle enforces adoption of a more appropriate vocal mechanism. Botulinum toxin as an adjunct to voice therapy should be considered before surgical alteration of the glottis in patients with recalcitrant mutational falsetto.