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da Silva DM, de Lacerda MM, Depolli GT, Azevedo EHM, Moreti F, Guimarães MF. Self-Perceived Vocal Symptoms and Discomfort in Amateur Church Singers. J Voice 2024:S0892-1997(24)00107-3. [PMID: 38705738 DOI: 10.1016/j.jvoice.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/22/2024] [Accepted: 03/26/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE To analyze self-perceived vocal symptoms and discomfort in amateur church singers and compare them between genders and church types. METHODS It was a quantitative cross-sectional study involving 99 amateur church singers aged between 18 and 59years. Data collection was carried out through the completion of a sociodemographic questionnaire, the Voice Symptom Scale (VoiSS), and the Vocal Tract Discomfort Scale (VTDS). The Mann-Whitney test was used for comparisons, and Spearman's correlation test was used for analyzing correlations between scale scores. The adopted significance level was 5% (P < 0.05). RESULTS There was a prevalence of females (71.7%), amateur singers from Protestant churches (73.7%), with a mean age of 27.5years. The average VoiSS total score was 22.6 points, the "limitation" domain was 12.3, the "emotional" domain was 2.55, and the "physical" domain was 7.7. The most self-perceived sensations in the VTDS were "dryness," "sore throat," and "itchiness" with mild to moderate intensity. There was a statistically significant difference between genders (P < 0.05) and a positive correlation from weak (r = 0.212) to strong magnitude (r = 0.660) between vocal symptoms and vocal tract discomfort. There was no statistically significant difference between types of churches. CONCLUSION Amateur singers self-report high levels of vocal symptoms, which impact limitation, emotional, and physical domains. Furthermore, they experience vocal tract discomfort sensations, with dryness being the most frequently reported, followed by sore throat and itching. No significant differences were found between the scale scores and church types. However, females reported a greater frequency and intensity of vocal tract discomfort sensations. The greater the self-reported vocal symptoms in this population, the higher their self-reported frequency and intensity of vocal tract discomfort sensations. These findings underscore the importance of addressing vocal health issues in amateur singers to enhance their overall well-being.
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Affiliation(s)
- Danielle Melo da Silva
- Speech-Language Pathology Department, Universidade Federal do Espírito Santo - UFES, Vitória, Espírito Santo, Brazil
| | - Mel Mutiz de Lacerda
- Speech-Language Pathology Department, Universidade Federal do Espírito Santo - UFES, Vitória, Espírito Santo, Brazil
| | - Gabriel Trevizani Depolli
- Speech-Language Pathology and Audiology Department, Faculdade de Filosofia e Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - Unesp, Marília, São Paulo, Brazil
| | - Elma Heitmann Mares Azevedo
- Speech-Language Pathology Department, Universidade Federal do Espírito Santo - UFES, Vitória, Espírito Santo, Brazil
| | - Felipe Moreti
- Speech-Language Pathology and Audiology Department, Faculdade de Filosofia e Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - Unesp, Marília, São Paulo, Brazil
| | - Michelle Ferreira Guimarães
- Speech-Language Pathology Department, Universidade Federal do Espírito Santo - UFES, Vitória, Espírito Santo, Brazil.
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Bhattarai A, Bhattarai B, Rana S. Prevalence of Occupational Voice Disorder Among Teachers of Kathmandu District, Nepal. Indian J Otolaryngol Head Neck Surg 2024; 76:1874-1881. [PMID: 38566690 PMCID: PMC10982201 DOI: 10.1007/s12070-023-04434-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 12/03/2023] [Indexed: 04/04/2024] Open
Abstract
The objective of this research was to identify the prevalence of voice disorders among teachers in the Kathmandu District of Nepal, with an emphasis on identifying possible risk factors that may be associated with these disorders. A cross-sectional study design was used, with both quantitative and qualitative data-gathering techniques using a mixed-methods approach. Data were collected from 95 non-teachers and 194 participating teachers from different schools in Kathmandu Valley. The analysis covered self-reported voice problem prevalence, job details, and demographic data. We examined the relationships between several variables and voice issues, including gender, class size, length of instruction, and tobacco usage. Findings: Compared with nonteachers (33.7%), teachers had a considerably greater prevalence of voice issues (69.1%). Greater class size and more than ten years of teaching experience were shown to be risk factors, while female instructors reported a greater prevalence of voice issues. Additionally, it was shown that instructors' voice issues are also linked to tobacco usage. The results of this study highlight how critical it is to provide voice therapy to educators employed in the Kathmandu District, particularly those in at-risk categories such as female instructors, more experienced educators, and educators with larger class sizes. The outcomes demonstrated important impacts on teacher well-being, job satisfaction, and academic achievement. More research and intervention strategies are needed to minimize the effects of voice problems and promote a positive teaching and learning environment.
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Affiliation(s)
- Ankit Bhattarai
- Speech and Hearing Unit, Department of ENT-HNS, Maharajgunj Medical Campus, Tribhuvan University, Kathmandu, Nepal
| | - Biraj Bhattarai
- All India Institute of Speech and Hearing, Mysore, Karnataka India
| | - Siju Rana
- Speech and Hearing Unit, Department of ENT-HNS, Maharajgunj Medical Campus, Tribhuvan University, Kathmandu, Nepal
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3
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Zhang F, Liu B, Wu P, Johnson C, Bouharati M, Zhang Y, He P, Jiang JJ. Nonlinear Dynamic Analysis and Perturbation Measurement Used for Discriminating Pathological Voices and Their Correlations With Perceptual Evaluation. J Voice 2024:S0892-1997(23)00320-X. [PMID: 38458820 DOI: 10.1016/j.jvoice.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/06/2023] [Accepted: 10/06/2023] [Indexed: 03/10/2024]
Abstract
OBJECTIVE 1. To investigate the discriminatory and diagnostic power of nonlinear dynamic analysis measures concerning voices from normal, benign, and malignant voice disorders. 2. To study the correlations of nonlinear dynamic analysis measures with perceptual ratings to evaluate the reliability of the objective acoustic analysis in predicting severity of voice. METHOD The perturbation analysis metrics used were Jitter%, Shimmer%, and signal-to-noise ratio. The nonlinear dynamic analysis metrics used were spectrum convergence ratio (SCR), nonlinear energy difference ratio (NEDR), and rate of divergence (ROD). Subjects were enrolled and divided into three groups based on laryngeal pathology: normal, benign, and malignant. Vowel sound and reading samples were recorded. Perceptual evaluation was applied to these voice samples to investigate correlations between metrics and auditory perception. RESULT Each metric was capable of discriminating laryngeal pathology, except for SCR in the case of distinguishing between benign and malignant pathologies. Perturbation analysis parameters had a moderate ability to differentiate between normal and benign pathologies, but were unable to characterize malignant pathologies for certain diseases, such as Reinke's edema. All metrics significantly correlated with perceptual G scores. Nonlinear dynamic analysis was superior when applied to cases of severe dysphonia, where linear metrics such as Jitter% and Shimmer% tended to lose utility. NEDR and ROD were successful at differentiating between the different pathologies, whereas SCR could not discriminate between the benign and malignant groups. CONCLUSION Perturbation and nonlinear dynamic analyses are comparable in their discriminating power with respect to normal and benign voices, and normal and malignant voices. The nonlinear dynamic analysis metrics NEDR and ROD may be superior in clinical settings with respect to discriminating voice pathology ranging from mild pathological voice to severe dysphonia, and with respect to discriminating benign and malignant voice. SCR was found unable to discriminate pathological voices.
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Affiliation(s)
- Fan Zhang
- Department of Otolaryngology, EENT Hospital, Fudan University, Shanghai, China
| | - Boquan Liu
- School of Humanities, Shanghai Jiaotong University, Shanghai, China
| | - Pinhong Wu
- Department of Surgery, Division of Otolaryngology Head and Neck Surgery, University of Wisconsin - Madison, Madison, Wisconsin
| | - Colbey Johnson
- Department of Surgery, Division of Otolaryngology Head and Neck Surgery, University of Wisconsin - Madison, Madison, Wisconsin
| | - Melissa Bouharati
- Department of Surgery, Division of Otolaryngology Head and Neck Surgery, University of Wisconsin - Madison, Madison, Wisconsin
| | - Yi Zhang
- Department of Otolaryngology, EENT Hospital, Fudan University, Shanghai, China
| | - Peijie He
- Department of Otolaryngology, EENT Hospital, Fudan University, Shanghai, China.
| | - Jack J Jiang
- Department of Surgery, Division of Otolaryngology Head and Neck Surgery, University of Wisconsin - Madison, Madison, Wisconsin
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Kaneko M, Sugiyama Y, Fuse S, Mukudai S, Hirano S. Physiological Effects of Voice Therapy for Aged Vocal Fold Atrophy Revealed by EMG Study. J Voice 2024; 38:376-383. [PMID: 34649741 DOI: 10.1016/j.jvoice.2021.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Age-related voice changes are characterized as breathy, weak and strained, and a deterioration in vocal function in the elderly has been putatively linked to a reduced intensity of speech. They contribute to undesirable voice changes known as presbyphonia. These changes are caused by histological alterations in the lamina propria of the vocal fold mucosa and atrophy of the thyroarytenoid muscle, as well as by decreased respiratory support. There are several clinical studies on presbylarynx dysphonia showing the effectiveness of voice therapy. However, physiological changes of the presbylarynx following voice therapy have not been verified. The purpose of this prospective study was to demonstrate the clinical effectiveness of voice therapy for rehabilitating presbylarynx dysphonia, using vocal function assessments and thyroarytenoid muscular activity detection on laryngeal electromyography (LEMG). METHODS 10 patients who were diagnosed with aged vocal fold atrophy from ages 60 to 87 years (mean age: 72 years) underwent approximately 12 weeks of voice therapy, mainly using forward-focused voice and vocal resistance training. Stroboscopic examination, aerodynamic assessment, acoustic analysis, Voice Handicap Index (VHI)-10, and LEMG were performed pre- and post-voice therapy. Vocal fold vibratory amplitude (VFVA) was measured by image analysis from the stroboscopic examinations. Turns analysis during steady phonation on LEMG was also assessed. RESULTS Maximum phonation time, subglottic pressure, jitter, shimmer, VFVA, and VHI-10 significantly improved after voice therapy. The number of turns per second on LEMG also significantly increased. CONCLUSION Our data suggest that voice therapy may improve vocal function and thyroarytenoid muscle activity in patients with aged vocal fold atrophy.
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Affiliation(s)
- Mami Kaneko
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
| | - Yoichiro Sugiyama
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
| | - Shinya Fuse
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
| | - Shigeyuki Mukudai
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
| | - Shigeru Hirano
- Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
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5
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Hirano S, Inufusa H, You F. The Effect of Oxidative Stress on the Human Voice. Int J Mol Sci 2024; 25:2604. [PMID: 38473848 DOI: 10.3390/ijms25052604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
The vocal fold vibrates in high frequency to create voice sound. The vocal fold has a sophisticated histological "layered structure" that enables such vibration. As the vibration causes fricative damage to the mucosa, excessive voicing can cause inflammation or injury to the mucosa. Chronic inflammation or repeated injury to the vocal fold occasionally induces scar formation in the mucosa, which can result in severe dysphonia, which is difficult to treat. Oxidative stress has been proven to be an important factor in aggravating the injury, which can lead to scarring. It is important to avoid excessive oxidative stress during the wound healing period. Excessive accumulation of reactive oxygen species (ROS) has been found in the injured vocal folds of rats during the early phase of wound healing. Antioxidants proved to be useful in preventing the accumulation of ROS during the period with less scar formation in the long-term results. Oxidative stress is also revealed to contribute to aging of the vocal fold, in which the mucosa becomes thin and stiff with a reduction in vibratory capacity. The aged voice can be characterized as weak and breathy. It has been confirmed that ROS gradually increases in rat vocal fold mucosa with age, which may cause further damage to the vocal fold. Antioxidants have also proved effective in avoiding aging of the vocal fold in rat models. Recently, human trials have shown significant effects of the antioxidant Twendee X for maintaining the voice of professional opera singers. In conclusion, it is suggested that oxidative stress has a great impact on the damage or deterioration of the vocal folds, and the use of antioxidants is effective for preventing damage of the vocal fold and maintaining the voice.
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Affiliation(s)
- Shigeru Hirano
- Department of Otolaryngology Head and Neck Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Haruhiko Inufusa
- Division of Antioxidant Research, Gifu University, Gifu 501-1194, Japan
| | - Fukka You
- Division of Antioxidant Research, Gifu University, Gifu 501-1194, Japan
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6
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Kirsch A, Grossmann T, Steffan B, Groselj-Strele A, Gerstenberger C, Gugatschka M. Vocal fold fibroblasts and exposure to vibration in vitro: Does sex matter? PLoS One 2024; 19:e0297168. [PMID: 38335206 PMCID: PMC10857603 DOI: 10.1371/journal.pone.0297168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/30/2023] [Indexed: 02/12/2024] Open
Abstract
Studies have shown that certain vocal fold pathologies are more common in one sex than the other. This is often explained by differences in the composition of the lamina propria and anatomical differences between female and male vocal folds, resulting in e.g. different fundamental frequencies. Here, we investigated a potential sex-specific voice frequency effect in an in vitro setting using vocal fold fibroblasts from one male and one female donor with and without cigarette smoke extract (CSE) addition. After exposure to either male or female vibration frequency with or without CSE, cells and supernatants were harvested. Gene and protein analysis were performed by means of qPCR, western blot, ELISA and Luminex. We found that exposure of cells to both male and female vibration pattern did not elicit significant changes in the expression of extracellular matrix-, inflammation-, and fibrosis-related genes, compared to control cells. The addition of CSE to vibration downregulated the gene expression of COL1A1 in cells exposed to the female vibration pattern, as well as induced MMP1 and PTGS2 in cells exposed to both female and male vibration pattern. The protein expression of MMP1 and COX2 was found to be significantly upregulated only in cells exposed to CSE and female vibration pattern. To conclude, different vibration patterns alone did not cause different responses of the cells. However, the female vibration pattern in combination with CSE had a tendency to elicit/maintain more pro-inflammatory responses in cells than the male vibration pattern.
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Affiliation(s)
- Andrijana Kirsch
- Division of Phoniatrics, ENT University Hospital, Medical University of Graz, Graz, Austria
| | - Tanja Grossmann
- Division of Phoniatrics, ENT University Hospital, Medical University of Graz, Graz, Austria
| | - Barbara Steffan
- Division of Phoniatrics, ENT University Hospital, Medical University of Graz, Graz, Austria
| | - Andrea Groselj-Strele
- Core Facility Computational Bioanalytics, Center for Medical Research, Medical University of Graz, Graz, Austria
| | - Claus Gerstenberger
- Division of Phoniatrics, ENT University Hospital, Medical University of Graz, Graz, Austria
| | - Markus Gugatschka
- Division of Phoniatrics, ENT University Hospital, Medical University of Graz, Graz, Austria
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7
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Polo N, Lã FMB. Self-Perceived Voice Handicap During COVID19 Compulsory Facemask Use: A Comparative Study Between Portuguese and Spanish Speakers. J Voice 2024; 38:105-111. [PMID: 34465480 PMCID: PMC8403057 DOI: 10.1016/j.jvoice.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 11/16/2022]
Abstract
This study investigates self-perceptions of voice-related handicap as a function of facemask use in the general working population during the COVID19 outbreak, using the Voice Handicap Index (VHI). Each VHI item was answered twice in a row; the first answer referred to the condition of not wearing a facemask (henceforth, the Without condition) and the second to the condition of using a facemask (henceforth, the With condition). VHI scores were collected via Google Forms (Google, Mountain View, California), targeting 2 groups of speakers of different nationalities, Portuguese (n = 261) and Spanish (n = 297). A Wilcoxon test was carried out to compare VHI scores between With and Without conditions for each group of speakers; a Mann-Whitney U test was used to compare groups within each condition. Results suggested that VHI overall scores and scores for all dimensions were higher for the With condition, for both Portuguese and Spanish speakers. When comparing groups of speakers, Spanish speakers presented higher scores for functional and emotional dimensions, for both With and Without conditions. In addition, the overall score for the Without condition was higher for Spanish speakers. No differences between groups were found for the total VHI score for the With condition. When comparing overall VHIdiff between speakers, that is, the difference in the VHI total score between With and Without conditions, no significant differences could be found. Thus, a multiple regression analysis was carried out between the VHIdiff and the independent variables of interest: age, sex, smoking habits, professional occupation, nationality, facemask type and its hours of use. The resulting model providing the highest association suggested that 2.5% of the variation in overall VHIdiff total score could be associated with sex, smoking habits, and professional level. Female smokers who use their voices during prolonged hours at work (e.g., teachers, lawyers, sales people) presented a higher VHI total score when wearing a mask. Future voice-related health interventions should address preventive strategies towards speaking behaviors leading to vocal fatigue and vocal effort as a consequence of compulsory facemask use, especially with respect to female professional voice users who smoke.
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Affiliation(s)
- Nuria Polo
- Department of Spanish Language and General Linguistics, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain.
| | - Filipa M B Lã
- Department of Didactics, School Organization and Special Didactics, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
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Düzenli-Öztürk S, Ünsal EM, Tetik-Hacıtahiroğlu K, Uz-Hasırcı S. Investigation of the Relationship Between Vocal Fatigue, Quality of Life, and Compliance With Vocal Hygiene in Professional Voice Users. J Voice 2023:S0892-1997(23)00325-9. [PMID: 37980208 DOI: 10.1016/j.jvoice.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 11/20/2023]
Abstract
PURPOSE Intensive voice use may lead to the development of voice disorders or voice complaints, such as vocal fatigue, for professional voice users (teachers, academics, call center workers, actors, singers, speech and language therapists, voice trainers, and religious officials). Vocal fatigue has a detrimental effect on occupational, emotional, and social performance, besides the quality of life of the individual. The effect of voice hygiene interventions on voice fatigue is not fully known. The results of studies conducted with different occupational groups are inconsistent. The present study aims to analyze the relationship between vocal fatigue and voice-related quality of life (V-RQOL) in professional voice users, and the impact of vocal hygiene on vocal fatigue. METHODS Participants (24 male, 90 female), who were professional voice users without any diagnosis of voice disorders or voice complaints were divided into two groups low vocal hygiene compliance (LVH; n = 66) and high vocal hygiene compliance (HVH; n = 48). In this study, vocal fatigue was measured by the vocal fatigue index (VFI), and V-RQOL was measured by the voice handicap index (VHI-10) and V-RQOL. RESULTS VFI subscales (tiredness, avoidance, physical discomfort) have a moderate positive correlation with VHI-10 and V-RQOL, which indicates that there is a significant relationship between vocal fatigue and quality of life amongst professional voice users. While there was no significant difference between the LVH and HVH groups in terms of quality of life, it was found that the vocal fatigue level of the LVH group was higher. CONCLUSION This study of professional voice users with healthy voices reveals a relationship between vocal fatigue and V-RQOL. Vocal hygiene compliance may affect professional voice users' vocal fatigue symptoms; the low-compliant group has higher levels of tiredness, avoidance, and physical discomfort. The findings highlight the importance of raising awareness of the problems of professional voice users, even though they have healthy voices and the need for vocal hygiene education programs that target them.
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Affiliation(s)
- Seren Düzenli-Öztürk
- Department of Speech and Language Therapy, Faculty of Health Sciences, Izmir Bakırçay University, Izmir, Turkey.
| | - Elif Meryem Ünsal
- Department of Speech and Language Therapy, Faculty of Health Sciences, Izmir Bakırçay University, Izmir, Turkey
| | - Kübra Tetik-Hacıtahiroğlu
- Department of Speech and Language Therapy, Faculty of Health Sciences, Izmir Bakırçay University, Izmir, Turkey
| | - Sema Uz-Hasırcı
- Department of Speech and Language Therapy, Faculty of Health Sciences, Izmir Bakırçay University, Izmir, Turkey
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Bhatt NK, Garber D, Baertsch H, Beard L, Giliberto JP, Meyer TK, Merati AL, Sauder C. Treatments for Age-related Vocal Atrophy: A Systematic Review. Laryngoscope 2023; 133:2846-2855. [PMID: 36912397 DOI: 10.1002/lary.30653] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 01/24/2023] [Accepted: 02/08/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE Age-related vocal atrophy (ARVA) can dramatically affect voice, communication, and quality of life. The objectives of this systematic review were to (1) determine whether treatments for ARVA were superior to controls (2) compare the relative efficacy of procedural and behavioral treatments (3) review the various types of outcome measures, and (4) evaluate the quality of studies. REVIEW METHODS The literature was searched using strategies designed by a medical librarian (2/18/21, updated 3/9/22). Studies investigating treatments for bilateral vocal atrophy were included. Studies involving unilateral atrophy, presbyphonia (without endoscopic findings), or an absent comparator group were excluded. The Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist was used to guide this study. RESULTS After applying the inclusion/exclusion criteria, 8 articles remained, including 4 randomized trials and 4 cohort studies, and a narrative synthesis was performed. Surgical and behavioral treatments for ARVA appeared to be superior to control groups, based on specific outcome measures. However, the superiority of these treatments over controls was not uniformly observed across multiple outcome measures. When comparing different treatments, superiority could not be established based on the quality and completeness of the studies included in the systematic review. Outcome measures also varied between individual studies. Finally, the risk of bias was analyzed and scored. Consistent point deductions among reviewed studies were noted. CONCLUSIONS When comparing treatments for ARVA. Surgery and voice therapy were both superior to control groups based on specific outcome measures from different domains. Superiority of one treatment could not be established. LEVEL OF EVIDENCE N/A Laryngoscope, 133:2846-2855, 2023.
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Affiliation(s)
- Neel K Bhatt
- Department of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, USA
| | - David Garber
- Department of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, USA
| | - Hans Baertsch
- Department of Otolaryngology - Head and Neck Surgery, University of Southern California Keck School of Medicine, Los Angeles, California, USA
| | - Lynly Beard
- Health Sciences Library, University of Washington School of Medicine, Seattle, Washington, USA
| | - J P Giliberto
- Department of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, USA
| | - Tanya K Meyer
- Department of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, USA
| | - Albert L Merati
- Department of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, Seattle, Washington, USA
| | - Cara Sauder
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
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10
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Santos SS, Christmann MK, Cielo CA. Spectrographic Vocal Characteristics in Female Teachers: Finger Kazoo Intensive Short-term Vocal Therapy. J Voice 2023:S0892-1997(23)00270-9. [PMID: 37838586 DOI: 10.1016/j.jvoice.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/22/2023] [Accepted: 08/22/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE Verify the results from intensive short-term vocal therapy using the Finger Kazoo technique about the spectrographic vocal measurements of teachers. METHODS Controlled and randomized trial. Spectrographic vocal assessment was performed by judges before and after intensive short-term vocal therapy with Finger Kazoo. Sample was composed of 41 female teachers. There were two study groups (with vocal nodules and without structural affection of the vocal folds) and the respective control groups. For the statistical analysis of the data, nonparametric tests were used (Mann-Whitney test and Wilcoxon test). RESULTS After intensive short-term vocal therapy with Finger Kazoo, improvement in voice spectral parameters, such as improvement in tracing (color intensity and regularity), greater definition of formants and harmonics, increased replacement of harmonics by noise, and a greater number of harmonics, mainly in the group without structural affection of the vocal folds. CONCLUSION There was an improvement in the spectrographic vocal parameters, showing greater stability, quality, and projection of the emission, especially in female teachers without structural affection of the vocal folds.
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Affiliation(s)
- Sabrina S Santos
- Departamento de Fonoaudiologia, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil.
| | - Mara K Christmann
- Departamento de Fonoaudiologia, Universidade do Vale do Itajaí (UNIVALI), Itajaí, SC, Brazil.
| | - Carla A Cielo
- Departamento de Fonoaudiologia, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil.
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11
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Andersen HS, Egsgaard MH, Ringsted HR, Grøntved ÅM, Godballe C, Printz T. Normative Voice Range Profile of the Young Female Voice. J Voice 2023; 37:546-552. [PMID: 34049760 DOI: 10.1016/j.jvoice.2021.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Normative data are important in the clinical setting of Speech and Language Pathology. The purpose of this study was to develop a normative reference dataset of voice range profiles from young females. STUDY DESIGN Descriptive study including a prospective collection of voice range profile data. METHODS Voice range profile recordings from 39 females with healthy voices aged 18 to 28 years were conducted. Seven voice range profile variables were analyzed: minimum and maximum fundamental frequency and intensity, semitone and intensity ranges, and voice range profile area. Descriptive statistical methods were applied. RESULTS An age-specific voice range profile normative dataset was established. The mean values and standard deviations were as follows: semitone range 34.7 ± 3.9 ST, minimum fundamental frequency 143.6 ± 21.7 hertz, maximum fundamental frequency 1063.5 ± 160 hertz, intensity range 65.6 ± 5.0 dB, minimum intensity 43.2 ± 2.5 dB SPL, maximum SPL 108.9 ± 5.1 dB SPL, and voice range profile area 1346 ± 222 cells. CONCLUSION A normative dataset usable for optimization of future voice assessments has been established. It may especially benefit evaluation and treatment planning for younger females suffering from vocal fold nodules.
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Affiliation(s)
| | | | - Helena Rask Ringsted
- Department of ORL Head & Neck Surgery, Odense University Hospital, Odense C, Denmark
| | - Ågot Møller Grøntved
- Department of ORL Head & Neck Surgery, Odense University Hospital, Odense C, Denmark
| | - Christian Godballe
- Department of ORL Head & Neck Surgery, Odense University Hospital, Odense C, Denmark
| | - Trine Printz
- Department of ORL Head & Neck Surgery, Odense University Hospital, Odense C, Denmark
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de Oliveira Lemos I, Picanço Marchand DL, Oliveira Cunha E, Alves Silvério KC, Cassol M. What are the Symptoms that Characterize the Clinical Condition of Vocal Fatigue? A Scoping Review and Meta-Analysis. J Voice 2023:S0892-1997(22)00419-2. [PMID: 36737268 DOI: 10.1016/j.jvoice.2022.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Vocal fatigue is a clinical manifestation associated with a perception of negative vocal adjustment. It is related to the increase in the sensation of excessive effort when speaking and the lack of conditioning of the muscles and structures that involve vocal production. Because it has a complex and multifactorial diagnosis, there is still no consensus on the symptoms most commonly found in this clinical condition. OBJECTIVE To review and analyze the symptoms that characterize the clinical condition of vocal fatigue. METHODS This study consists of a scoping review carried out in the Cochrane Library, Embase, Lilacs, and Medline databases. Observational studies or clinical trials from the last 10 years. Studies with participants younger than 18 years of age were excluded; as well as research that did not describe symptoms of vocal fatigue or that presented vocal fatigue as a symptom; studies with patients with neurological, psychiatric, syndromic conditions, or head and neck cancer. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies NHLBI-NIH scale was used to assess the methodological quality of selected observational studies and the PEDro scale for the analysis of experimental studies. The steps were performed by three blinded evaluators. Subsequently, meta-analyses of global means were executed for each factor under study; a comparison of the difference in the mean score for each factor between exposed and unexposed; a comparison of the difference in the average score, among non-professional voice users, for each factor between exposed and unexposed. RESULTS In the searches performed, 956 articles were found and 29 articles were selected according to the eligibility criteria. Of these, 93.11% of the studies were observational and 6.89% were clinical trials. Regarding the gender and age group of the study samples, women aged between 30 and 45 years were predominant. As for the occupational use of voice, 68.97% of the samples were composed of professional voice users and 31.03% of non-professional voice users, with most professional voice users being teachers and non-professional voice users, individuals with dysphonia or vocal complaint. To assess vocal fatigue symptoms, 28 studies used the Vocal Fatigue Index (VFI) protocol, and only one study used another assessment protocol, Self-Administered Voice Rating. All studies were classified as regular, according to the scale used. As for the meta-analyses performed, the mean scores of the VFI factors were higher among professional voice users when compared to non-professional voice users and higher in dysphonic individuals compared to non-dysphonic individuals. CONCLUSION The vocal fatigue symptoms found in this review were common in the populations of professional voice users and non-professional voice users and dysphonic and non-dysphonic individuals. These symptoms were related to vocal recovery after rest, physical discomfort, and restricted vocal use.
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Affiliation(s)
- Isadora de Oliveira Lemos
- Rehabilitation Sciences Program, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Daniel Lucas Picanço Marchand
- Rehabilitation Sciences Program, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Eduarda Oliveira Cunha
- Health Sciences Program, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Kelly Cristina Alves Silvério
- Speech-Language Pathology and Audiology Department, Bauru School of Dentistry, São Paulo College, Bauru, São Paulo, Brazil.
| | - Mauriceia Cassol
- Rehabilitation Sciences Program And Speech, Language, and Hearing Sciences Department. Federal University of Health Sciences of Porto Alegre, Porto alegre, Rio Grande do Sul, Brazil.
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Berti LC, Spazzapan EA, Queiroz M, Pereira PL, Fernandes-Svartman FR, Medeiros BRD, Martins MVM, Ferreira LS, Silva IGGD, Sabino EC, Levin AS, Finger M. Fundamental frequency related parameters in Brazilians with COVID-19. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:576. [PMID: 36732219 DOI: 10.1121/10.0016848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 12/21/2022] [Indexed: 06/18/2023]
Abstract
This study compares fundamental frequency (fo) and fundamental frequency standard deviation (foSD) of COVID-19 patients with the same parameters in the speech of subjects without COVID-19, and verifies whether there is an effect of age and sex in the patient group. Both groups, subjects with and without COVID-19, are formed by Brazilian Portuguese speakers. Speech samples were obtained from 100 patients with mild to severe symptoms of COVID-19, and 100 healthy subjects. A single 31-syllable Portuguese sentence was used as the elicitation material for all subjects. The recordings were divided into four age groups. The acoustic measures were semi-automatically extracted and analyzed by a series of analyses of variance. Patients with COVID-19 present vocal differences in fo-related parameters when compared to healthy subjects, that is, patient voices presented higher fo and foSD with respect to control voices. In addition, for patient voices, there was an age and sex effect on fo SD values. Vocal parameters of women and elderly subjects showed more marked differences in fo-related parameters, indicating that patient voices are higher-pitched and have a higher variation of fo SD. Consequently, fo-related parameters may be tested as vocal biomarkers in the screening of respiratory insufficiency by voice analysis, in patients with severe symptoms of COVID-19.
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Affiliation(s)
- Larissa Cristina Berti
- Speech-Language Pathology and Audiology department, São Paulo State University, Marília, São Paulo, 17525-900, Brazil
| | - Evelyn Alves Spazzapan
- Speech-Language Pathology and Audiology department, São Paulo State University, Marília, São Paulo, 17525-900, Brazil
| | - Marcelo Queiroz
- Computer Science Department, University of São Paulo, São Paulo, São Paulo state, 05508-090, Brazil
| | - Pedro Leyton Pereira
- Computer Science Department, University of São Paulo, São Paulo, São Paulo state, 05508-090, Brazil
| | | | | | | | - Letícia Santiago Ferreira
- Classic and Vernacular Letters Department, University of São Paulo, São Paulo, São Paulo state, 05508-090, Brazil
| | | | - Ester Cerdeira Sabino
- Institute for Tropical Medicine (IMT), University of Sao Paulo, São Paulo, São Paulo State, 05508-090, Brazil
| | - Anna Sara Levin
- Institute for Tropical Medicine (IMT), University of Sao Paulo, São Paulo, São Paulo State, 05508-090, Brazil
| | - Marcelo Finger
- Computer Science Department, University of São Paulo, São Paulo, São Paulo state, 05508-090, Brazil
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Voice Disorders in Lower Primary School Teachers: An Observational Study. J Voice 2023; 37:141.e1-141.e8. [PMID: 33349479 DOI: 10.1016/j.jvoice.2020.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/03/2020] [Accepted: 12/03/2020] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Voice problems are very common among teachers, and etiology-based methods are used in the diagnosis and treatment process. Our study aims to reveal the changes in subjective voice analysis during the diagnosis and treatment process of dysphonia in lower primary school teachers. METHODS The nature of the study is a prospective observational one designed for lower primary school teachers in Kahramanmaraş conducted between the year 2015 and 2019 and evaluations for parameters including sociodemographic characteristics, laryngeal lesions and pre- and post-treatment scales such as Voice Handicap Index-10 (VHI-10), Reflux Symptom Index (RSI) and Hospital-Anxiety Depression Scale (HADS) for treatment subgroups were made. Statistical analysis was analyzed using SPSS. RESULTS Three hundred and fifty-one lower primary school teachers were included in the study. A statistically significant difference was found for the development of dysphonia in terms of sociodemographic features such as smoking, professional experience and crowdedness of classroom. Changes in RSI, VHI-10 and HADS values after treatment were clinically significant in all treatment groups. While there was a significant post-treatment improvement in terms of RSI in patients with granuloma and laryngopharyngeal reflux disorders, the VHI-10, and HADS assessments revealed a significant difference in clinical recovery compared to laryngeal lesions. CONCLUSION The RSI, VHI-10 and HADS values for various laryngeal pathologies were found to be high in dysphonic teachers. An improvement was observed in the scale scores upon the application of treatment modalities. This situation emphasizes the importance of questionnaire survey in the diagnosis, treatment, and follow-up process of dysphonia.
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Liu Z, Zhang C, Wang X, Zhang J, Liu L, Wang J, Zhao J, Zou S, Ma X, Li J. Characteristics of Laryngopharyngeal Reflux in Patients of Different Genders and Ages. J Voice 2022:S0892-1997(22)00387-3. [PMID: 36567235 DOI: 10.1016/j.jvoice.2022.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To investigate the differences in laryngopharyngeal reflux (LPR) characteristics between gender and age groups based on the Reflux Symptom Index (RSI), Reflux Finding Score (RFS) scale and 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH (HEMII-pH) monitoring. METHODS The enrolled were patients with LPR symptoms completed the 24h-HEMII-pH monitoring and divided into two gender groups (male and female) and elderly group (>60 years), middle-aged group (41-60 years) and young group (18-40 years). The total RSI and RFS scores of individuals were counted. Various potential differences as well as incidence of each type of LPR events between gender and age groups were analyzed. RESULTS A total of 420 patients were included, with 333 (79.3%) diagnosed with LPR confirmed by 24h-HEMII-pH monitoring. Females (n=49) had a statistically higher LPR positivity (91.0% vs. 76.6%, P < 0.01) than males (n=342). Female patients with LPR had significantly higher RSI scores (14.08 ± 6.72 vs. 11.08 ± 4.82, P < 0.001) than male patients. The positive rate of LPR were 82.6%, 80.7% and 63.3% in the elderly, middle-aged and young groups. The Elderly group had significantly lower RSI scores (10.20 ± 4.06 vs. 12.80 ± 6.58, 12.24 ± 5.57, P < 0.001) but higher RFS scores (9.37 ± 3.25 vs. 8.16 ± 3.34, 8.57 ± 2.58, P < 0.05) than the other two groups. The number of acid hypopharyngeal-proximal reflux episodes (HREs) and distal esophageal acid reflux were significantly higher in elderly than in young patients. Except for non-acid gas HREs, the positive rates of other types of HREs were increasing from young to middle-aged to the elderly group (P < 0.05). CONCLUSIONS Female patients with suspected LPR symptoms had a higher positive rate of LPR and RSI score than males. The prevalence of LPR and the number of acid reflux were progressively increasing with age, but the perception of reflux symptoms may diminish.
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Affiliation(s)
- Zhi Liu
- Navy Clinical College, the Fifth School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, P.R.China; Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Chun Zhang
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Xiaoyu Wang
- Navy Clinical College, the Fifth School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, P.R.China; Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Jinhong Zhang
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Lianlian Liu
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Jiasen Wang
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Jing Zhao
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Shizhen Zou
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Xin Ma
- Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China
| | - Jinrang Li
- Navy Clinical College, the Fifth School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, P.R.China; Department of Otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, Beijing, P.R.China.
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González-Gamboa M, Segura-Pujol H, Oyarzún PD, Rojas S. Are Occupational Voice Disorders Accurately Measured? A Systematic Review of Prevalence and Methodologies in Schoolteachers to Report Voice Disorders. J Voice 2022:S0892-1997(22)00348-4. [PMID: 36496306 DOI: 10.1016/j.jvoice.2022.10.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Different measuring instruments have been described to determine the prevalence of voice disorders in schoolteachers. However, the heterogeneity of prevalence figures has made it difficult in determining the impact of voice disorders in this group. This investigation aims to review and identify scientific evidence of methodological analysis of voice disorders in teachers, the relevance of measuring instruments, the prevalence of dysphonia, and the impact on the development of vocal health prevention programs. METHODS A systematic review was conducted by searching six important scientific databases. Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines were carried out. Articles were included whether they presented data related to the prevalence of dysphonia and the impact of therapy programs on teachers. RESULTS Twenty articles out of 8,998 were selected. The cross-sectional design type was predominant throughout the investigations. Differences were observed in the number of participants across studies, leading to heterogeneous prevalence figures - which ranged from 10.5% to 69.1%. The assessment instruments are not standardly used to effectively determine the disease burden. Despite the fact of the extensive evidence of the effectiveness of programs that address dysphonia in teachers, the scarcity of literature is yet evident on systematic programs promoted by either the government or educational institutions. CONCLUSION Findings suggest that future investigations should consider the consensus of a global definition for occupational dysphonia in teachers in order to develop accurately measuring instruments and to assist with voice care programs and treatment approaches in this population. This might be crucial since it could also assist with the implementation of Delphi-type studies that could support the development of further evidence-based agreements around these programs (voice care and treatment approaches) in schoolteachers.
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Affiliation(s)
| | - Hugo Segura-Pujol
- Escuela de Fonoaudiología, Facultad de Salud, Universidad Santo Tomás, Chile
| | - Patricia D Oyarzún
- Escuela de Fonoaudiología, Facultad de Salud, Universidad Santo Tomás, Chile
| | - Sandra Rojas
- Escuela de Fonoaudiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile
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Joshi AA, Mukundan P, Dave VJ, Bradoo RA, Dhorje NR. Prevalence of Voice Disorders in Indian Female Secondary School Teacher Population-A Cross Sectional Study. Indian J Otolaryngol Head Neck Surg 2022; 74:2324-2330. [PMID: 36452570 PMCID: PMC9702264 DOI: 10.1007/s12070-020-02160-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 09/15/2020] [Indexed: 11/26/2022] Open
Abstract
Teachers are the backbone of any civilized society as they are the keepers of knowledge, wisdom and values. Lack of infrastructure, manpower and resources makes voice the most important tool for a teacher. Teachers need to speak loudly for long periods often under unfavourable circumstances. Increased vocal effort and incorrect phonation techniques can lead to vocal fold tissue damage and vocal fold pathologies and hence voice problems producing adverse effects on teaching performance. To study the prevalence of voice disorders in Indian female secondary school teacher population. To identify the risk factors for the development of voice disorders. A multicentric, cross-sectional observational study of 200 teachers were conducted in 4 schools over a period of 2 years. Female teachers who gave consent and were willing for follow up were included in the study. Details were collected using a structured questionnaire. Subjective analysis by VHI, perceptual analysis by GRABS score, acoustic analysis and direct visualization using Hopkins 70° rigid laryngoscope were done.The prevalence of voice disorders was 18.5%. Risk factors identified were age group 41-60 years, repeated respiratory allergies, comorbidities, constitutional symptoms, increased number of years of teaching and number of lecture hours per week. VHI, GRABS, Acoustic analysis findings were consistent with Rigid Laryngoscopic finding making them effective tools in the assessment of voice.
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Affiliation(s)
- Anagha A. Joshi
- Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, 400022 India
| | - Prathibha Mukundan
- Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, 400022 India
| | - Varun J. Dave
- Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, 400022 India
| | - Renuka A. Bradoo
- Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, 400022 India
| | - Nikhil R. Dhorje
- Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, 400022 India
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Alshuhayb BS, Alkhars AZ, AlMaghlouth MK, Alkhars FS, Alamer ZA, Alarfaj AA, AlYahya KA. Voice Disorders Among Teachers in Al-Ahsa, Eastern Region, KSA: Vocal Complaints, Treatment-Seeking Behaviors, and Knowledge of Vocal Care. J Voice 2022:S0892-1997(22)00204-1. [PMID: 35970654 DOI: 10.1016/j.jvoice.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/03/2022] [Accepted: 07/05/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Voice disorders are a serious and common complaint among teachers, yet there are no published studies on these conditions in the context of Al-Ahsa city in the eastern region of the Kingdom of Saudi Arabia. This study analyzed the vocal complaints of Saudi teachers, investigated their treatment-seeking behaviors, and assessed their knowledge of vocal care. METHODS A cross-sectional online survey was randomly distributed to 604 Saudi teachers from December 2021 to March 2022. The data included sociodemographic characteristics, academic statuses, vocal symptoms and their effects, and attitudes toward voice problems. Statistical analysis was done using the Statistical Package for the Social Sciences (v. 23). Categorical variables were expressed as frequencies and percentages. A chi-square test was conducted to verify the association between the categorical variables. RESULTS Of the participants, 62.1% were female. 65.4% reported having voice-related problems, with the most frequently reported symptoms being hoarseness (68.35%), throat dryness (60.76%), and sore throat (56.46%). Out of the participants who reported voice problems, 32.15% stated being affected by absenteeism from school. Only a minority of teachers sought medical help (5.1%) or received information about the vocal care (29.5%). The factors that were found to be significantly associated with voice complaints include female gender, positive family history of vocal disorders, speaking in a loud voice, being non-smoker, and having the high number of classes per week (P < 0.05). CONCLUSION Voice-related complaints were highly prevalent among Saudi teachers for multiple factors, most of which were manageable. This study strongly recommends the vocal educational programs to be implemented during student teacher training.
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Affiliation(s)
| | | | | | | | - Zainab A Alamer
- King Faisal University, College of Medicine, Al Ahsa, Saudi Arabia
| | | | - Khalid A AlYahya
- King Faisal university, department of surgery otolaryngology unit.
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Elghouche AN, Nwosu OI, Jones AJ, Shin TJ, Matt BH, Anthony BP. Inflammatory Reactions to Laryngeal Injection of Hyaluronic Acid Derivatives. J Voice 2022:S0892-1997(22)00206-5. [PMID: 35945097 DOI: 10.1016/j.jvoice.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/05/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVES/HYPOTHESIS To report the rate and describe the characteristics and management of inflammatory reactions following injection laryngoplasty with hyaluronic acid derivatives. STUDY DESIGN Single institution, retrospective review. METHODS Adult and pediatric patients who underwent injection laryngoplasty with hyaluronic acid derivatives from 2013 to 2020 were identified. Demographics, indication for injection, type and volume of injected material, and use of general anesthesia were obtained. When a postoperative inflammatory response occurred, information regarding clinical presentation, timing, and subsequent management was collected. RESULTS A total of 464 patients who underwent 536 laryngeal injections with hyaluronic acid derivatives were included. There were 365 adult patients (median age 62 years) who underwent 431 injections and 99 pediatric patients (median age 2 years) who underwent 105 injections. The most common indications for injection were abnormal vocal fold mobility (70.3%) and aspiration (83.8%) for adult and pediatric patients, respectively. Juvéderm® was used in 449 cases (79.8% adult, 100% pediatric), and Restylane® was used in the remaining adult cases (20.2%). Procedures were mostly performed under general anesthesia (67.7% adult, 100% pediatric) with median injection volumes of 0.6 mL for adult and 0.3 mL for pediatric patients. An inflammatory reaction occurred following 3 of 536 injections (0.6%), all utilizing Juvéderm®. All three patients presented with stridor, dyspnea, and laryngeal edema within two days of injection. Each patient was admitted for observation and successfully treated with intravenous steroids and inhaled racemic epinephrine. One patient with comorbid pneumonia was intubated and required concomitant treatment with broad-spectrum antibiotics. CONCLUSIONS Inflammatory reactions to hyaluronic acid derivatives used in injection laryngoplasty are rare but represent significant patient morbidity and can be managed with anti-inflammatory and airway stabilizing measures. Patients should be counseled appropriately regarding the risks of injection laryngoplasty with hyaluronic acid derivatives.
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Affiliation(s)
- Alhasan N Elghouche
- Indiana University School of Medicine, Department of Otolaryngology - Head and Neck Surgery, Indianapolis, Indiana
| | - Obinna I Nwosu
- Harvard Medical School, Department of Otolaryngology - Head & Neck Surgery, Boston, Massachusetts
| | - Alexander J Jones
- Indiana University School of Medicine, Department of Otolaryngology - Head and Neck Surgery, Indianapolis, Indiana.
| | - Timothy J Shin
- Indiana University School of Medicine, Department of Otolaryngology - Head and Neck Surgery, Indianapolis, Indiana
| | - Bruce H Matt
- Indiana University School of Medicine, Department of Otolaryngology - Head and Neck Surgery, Indianapolis, Indiana
| | - Benjamin P Anthony
- Indiana University School of Medicine, Department of Otolaryngology - Head and Neck Surgery, Indianapolis, Indiana
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Altundaş Hatman E, Torun SD. Occupational diseases among call center operators needing vocal rehabilitation. LA MEDICINA DEL LAVORO 2022; 113:e2022026. [PMID: 35766645 PMCID: PMC9437654 DOI: 10.23749/mdl.v113i3.12897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Work related diseases (WRDs) and occupational diseases (ODs) greatly affect call center operators (CCOs) who experience demanding work expectations and adverse working conditions in their workplace. The aim of this study was to evaluate the sociodemographic and job characteristics of CCOs diagnosed with OD, and to describe the changes in employment status after diagnosis. METHODS This descriptive study is based on the electronic data records of Istanbul Occupational Diseases Hospital available from February 2007 to March 2018. RESULTS According to the health board reports, 122 of the 173 (70.5%) CCOs had a confirmed OD diagnosis, 85.2% were females and the mean age was 27.5 years. Vocal cord disorders were the most frequent ODs (64.8%), followed by hearing loss (12.5%), dysphonia (10.2%) and temporomandibular disorders (4.7%). Vocal cord nodules (VCN) were found to be more frequent among females compared to males (92.9% vs 62.4%, p<0.001). Although not statistically significant, the frequency of VCN was also higher in subjects working overtime (14.6% vs 6.3%), having gastroesophageal reflux disease (82.3% vs 73.9%) or thyroid nodules (100% vs 73.7%) and being current smokers (41.7% vs 13.3%). Following the OD diagnosis, 43.8% of the cases were dismissed, 18.7% quit their job, and 9.4% still held the same job position. Only 28.1% changed unit within the workplace. CONCLUSION Including the CCOs who were diagnosed with an OD at a very young age and at an early stage of their working life into vocational rehabilitation programs and employing them under appropriate conditions is essential to proper health and safety protocol.
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González AD, de Almeida Lopes ACB, de Andrade SM, Gabani FL, da Silva Santos MC, Rodrigues R, Mesas AE. Schoolteachers with voice handicap are twice as likely to report depressive symptoms. Eur Arch Otorhinolaryngol 2022; 279:4043-4051. [PMID: 35441894 PMCID: PMC9249687 DOI: 10.1007/s00405-022-07376-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/23/2022] [Indexed: 11/13/2022]
Abstract
This study aimed to examine the association between voice disorder and depressive symptoms in schoolteachers. A cross-sectional survey was conducted with elementary and secondary schoolteachers. Voice disorders and depressive symptoms were assessed with the Voice Handicap Index-10 and the Beck Depression Inventory-II, respectively. Logistic and linear regressions models were adjusted for confounding variables. In the 389 schoolteachers studied, the prevalence of voice handicap and depressive symptoms was 18.8 and 38.8%, respectively. Voice handicap was associated with depressive symptoms on all models tested. The logistic regression showed an odds ratio of 2.21 (95% confidence interval: 1.19, 4.08; p value < 0.05), while in the linear regression each point increase on the voice disorder scale increased the Beck Depression Inventory-II score by 0.39 points (95% confidence interval: 0.26, 0.54; p value < 0.05). This study showed that teachers of public schools with voice handicap are twice as likely to report depressive symptoms.
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Affiliation(s)
- Alberto Durán González
- Postgraduate Program in Public Health, Health Sciences Center, State University of Londrina, Av. Robert Koch, n° 60, Londrina, 86038-350, Brazil
| | - Ana Carolina Bertin de Almeida Lopes
- Postgraduate Program in Public Health, Health Sciences Center, State University of Londrina, Av. Robert Koch, n° 60, Londrina, 86038-350, Brazil
| | - Selma Maffei de Andrade
- Postgraduate Program in Public Health, Health Sciences Center, State University of Londrina, Av. Robert Koch, n° 60, Londrina, 86038-350, Brazil
| | - Flávia Lopes Gabani
- Department of Nursing, Health Sciences Center, State University of Londrina, Londrina, Brazil
| | - Mayara Cristina da Silva Santos
- Postgraduate Program in Public Health, Health Sciences Center, State University of Londrina, Av. Robert Koch, n° 60, Londrina, 86038-350, Brazil
| | - Renne Rodrigues
- Postgraduate Program in Public Health, Health Sciences Center, State University of Londrina, Av. Robert Koch, n° 60, Londrina, 86038-350, Brazil
| | - Arthur Eumann Mesas
- Postgraduate Program in Public Health, Health Sciences Center, State University of Londrina, Av. Robert Koch, n° 60, Londrina, 86038-350, Brazil. .,Universidad de Castilla-La Mancha, Health and Social Research Centre, Cuenca, Spain.
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Plec EMRL, Côrtes Gama AC, Souza BO, Santos MAR. Effect of Nebulization on Laryngeal Parameters: Analysis Using High-Speed Digital Videolaryngoscopy. J Voice 2022:S0892-1997(22)00014-5. [PMID: 35288013 DOI: 10.1016/j.jvoice.2022.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Superficial laryngeal hydration, obtained through nebulization, is related to the moisture level on the epithelial surfaces of the vocal folds, modifying their biomechanical and aerodynamic properties. Through high-speed videolaryngoscopy it is possible to obtain objective data for laryngeal analysis after nebulization and a better understanding of this phenomenon OBJECTIVE: To verify the effects of nebulization with saline solution on laryngeal parameters of digital videokymography obtained by high-speed videolaryngoscopy examination in women and men with and without laryngeal alterations METHOD: This is a clinical, comparative intra-subject study. Fifty-nine adults were selected, with and without laryngeal alterations, 30 females and 29 males. Digital videokymographs in the anterior, middle and posterior thirds of the vocal folds of the participants were analyzed before and after nebulization with 0.9% saline solution. RESULTS Women without laryngeal alterations showed more parameters changes after nebulization, in which there was a decrease in maximum and medium opening, amplitude of opening of the left and right vocal fold in the anterior glottal third, and an increase of the percentage of closure of the vocal folds. These results indicate a minor extent of lateral excursion of the vocal folds during phonation. In women with laryngeal alterations, the parameters that changed after nebulization were the increased frequency of opening of the left and right vocal folds in the topography of the posterior third. In men, nebulization did not change the variables studied, except for the amplitude of the right vocal fold in men with laryngeal alterations, in the analysis of the posterior glottic third. CONCLUSION The results suggest that surface hydration modifies laryngeal dynamics differently between genders. After nebulization with saline solution, women without laryngeal alterations showed a decrease in the lateralization of the vocal folds during phonation, suggesting a better phonatory efficiency.
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Affiliation(s)
- Elisa Meiti Ribeiro Lin Plec
- Department of the Faculdade de Medicina - Universidade Federal de Minas Gerais - UFMG. Av. Alfredo Balena, Otolaryngologist of the Hospital Felício Rocho Belo Horizonte, Belo Horizonte Minas Gerais, Brasil.
| | - Ana Cristina Côrtes Gama
- Universidade Federal de Minas Gerais - Postgraduate program of the Speech and Language Department of the Faculdade de Medicina - Universidade Federal de Minas Gerais - UFMG. Av. Alfredo Balena, Belo Horizonte Minas Gerais, Brasil
| | - Bárbara Oliveira Souza
- Department of the Faculdade de Medicina - Universidade Federal de Minas Gerais - UFMG. Av. Alfredo Balena, Belo Horizonte Minas Gerais, Brasil
| | - Marco Aurélio Rocha Santos
- Department of the Faculdade de Medicina - Universidade Federal de Minas Gerais - UFMG. Av. Alfredo Balena, Professor of the Universidade Federal de Minas Gerais - Otolaryngologist of the Hospital Felício Rocho - Belo Horizonte, Belo Horizonte Minas Gerais, Brasil
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Ravikrishnan A, Fowler EW, Stuffer AJ, Jia X. Hydrogel-Supported, Engineered Model of Vocal Fold Epithelium. ACS Biomater Sci Eng 2021; 7:4305-4317. [PMID: 33635635 DOI: 10.1021/acsbiomaterials.0c01741] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
There is a critical need for the establishment of an engineered model of the vocal fold epithelium that can be used to gain understanding of its role in vocal fold health, disease, and facilitate the development of new treatment options. Toward this goal, we isolated primary vocal fold epithelial cells (VFECs) from healthy porcine larynxes and used them within passage 3. Culture-expanded VFECs expressed the suprabasal epithelial marker cytokeratin 13 and intercellular junctional proteins occludin, E-cadherin, and zonula occludens-1. To establish the engineered model, we cultured VFECs on a hyaluronic acid-derived synthetic basement membrane displaying fibronectin-derived integrin-binding peptide (RGDSP) and/or laminin 111-derived syndecan-binding peptide AG73 (RKRLQVQLSIRT). Our results show that matrix stiffness and composition cooperatively regulate the adhesion, proliferation, and stratification of VFECs. Cells cultured on hydrogels with physiological stiffness (elastic shear modulus, G' = 1828 Pa) adopted a cobblestone morphology with close cell-cell contacts, whereas those on softer matrices (G' = 41 Pa) were spindle shaped with extensive intracellular stress fibers. The development of stratified epithelium with proliferating basal cells and additional (1-2) suprabasal layers requires the presence of both RGDSP and AG73 peptide signals. Supplementation of cytokines produced by vimentin positive primary porcine vocal fold fibroblasts in the VFEC culture led to the establishment of 4-5 distinct cell layers. The engineered vocal fold epithelium resembled native tissue morphologically; expressed cytokeratin 13, mucin 1, and tight/adherens junction markers; and secreted basement membrane proteins collagen IV and laminin 5. Collectively, our results demonstrate that stiffness matching, cell-matrix engagement, and paracrine signaling cooperatively contribute to the stratification of VFECs. The engineered epithelium can be used as a versatile tool for investigations of genetic and molecular mechanisms in vocal fold health and disease.
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Affiliation(s)
- Anitha Ravikrishnan
- Department of Materials Science and Engineering, University of Delaware, Newark, Delaware 19716, United States
| | - Eric W Fowler
- Department of Materials Science and Engineering, University of Delaware, Newark, Delaware 19716, United States
| | - Alexander J Stuffer
- Department of Biological Sciences, University of Delaware, Newark, Delaware 19716, United States
| | - Xinqiao Jia
- Department of Materials Science and Engineering, University of Delaware, Newark, Delaware 19716, United States.,Department of Biological Sciences, University of Delaware, Newark, Delaware 19716, United States.,Department of Biomedical Engineering, University of Delaware, Newark, Delaware 19716, United States.,Delaware Biotechnology Institute, University of Delaware, Newark, Delaware 19711, United States
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Granjeiro RC, Oliveira LCDC, Dias MA, Oliveira CFD, Oliveira GMGF. Videolaryngoscopy Findings of the Vocal Health Program in Dysphonic Teachers in the Federal District, Brazil. Int Arch Otorhinolaryngol 2021; 26:e243-e249. [PMID: 35602277 PMCID: PMC9122771 DOI: 10.1055/s-0041-1733929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/25/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction
The high phonatory demand required of teachers is a direct cause of the onset of vocal symptoms and of the development of laryngeal disorders.
Objective
To describe the findings of the laryngeal screening performed as part of the Vocal Health Program held in the Federal Distrcit of Brazil in 2014 and 2015.
Methods
The study was performed with 361 dysphonic teachers from public schools who attended the laryngeal screening (videolaryngoscopy) part of the program. Data on anamnesis, the degree of dysphonia, the findings of the laryngeal screening, the referrals made after the laryngeal screening, and the result of the assessment of vocal aptitude for work were analyzed from the forms of each participating teacher.
Results
The sample of the present study (
N
= 361) represents 18.23% of the 1,980 teachers that went through the vocal screening of the program in 2014 and 2015. In total, 98 (27.15%) teachers presented mild dysphonia, 221 (61.22%), moderate dysphonia, and 42, (11.63%) severe dysphonia. Regarding the laryngeal screening (videolaryngoscopy exam), 269 teachers (74.52%) presented laryngeal disorders, and the main ones found were vocal nodules (43.87%), signs of laryngopharyngeal reflux (37.17%), hourglass chink (18.22%), vascular dysgenesis (18.22%), midposterior triangular chink (9.67%), and double chink (8.55%).
Conclusion
Laryngeal screening through videolaryngoscopy and auditory-perceptual screening of the voice as part of vocal health programs are essential to define the diagnosis and therapeutic conduct for teachers with dysphonia. Together with intervention activities, continuing education and adequate and accessible treatment, the periodic evaluation of vocal health can contribute to reduce absenteeism and improve the quality of life and of the voice of teachers.
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Affiliation(s)
- Ronaldo Campos Granjeiro
- Escola Superior de Ciências da Saúde, Brasília, DF, Brazil
- Hospital de Base do Distrito Federal, Brasília, Distrito Federal, Brazil
- Governo do Distrito Federal, Gerência de Promoção à Saúde do Servidor, Brasília, Distrito Federal, Brazil
| | | | - Mirela Alves Dias
- Governo do Distrito Federal, Gerência de Promoção à Saúde do Servidor, Brasília, Distrito Federal, Brazil
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Penha PBDC, Lima Filho LMDA, Ferreira LP, Almeida AAFD, Lopes LW, Lima Silva MFBD. Effectiveness of a Blended-Learning Intervention in Teachers' Vocal Health. J Voice 2021:S0892-1997(21)00102-8. [PMID: 34127331 DOI: 10.1016/j.jvoice.2021.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To verify the effectiveness of a blended-learning voice assistance program for elementary school teachers. STUDY DESIGN Nonrandomized and comparative interventional clinical trial. METHODS A total of 59 teachers participated; 33 of the 59 teachers participated in face-to-face learning (control group-CG), and 26 of the 59 teachers participated in blended learning (experimental group-EG). The Voice Assistance Program included the following for both groups: preintervention assessment, four voice workshops and postintervention assessment. The instruments used were the Vocal Production Condition - Teacher (VPC-T) questionnaire, the Screening Index for Voice Disorder (SIVD), the Vocal Health and Hygiene Questionnaire (VHHQ) and the Voice-Related Quality of Life (V-RQOL) measure. Additionally, voice samples were collected for auditory-perceptual analysis of voice quality. The workshops included theoretical and practical content for both groups. All the workshops for the CG were conducted face-to-face, while the workshops for the EG consisted of two online workshops and two face-to-face workshops. A descriptive analysis of the data was performed, and paired Wilcoxon and Mann-Whitney tests were performed using R software, with a significance level of 0.05. RESULTS Both groups showed improved acquisition of knowledge regarding vocal health and improved voice quality, but the improvement was greater for the EG. There was a significant decrease in the risk of voice disorder in the EG. Only the CG showed significant improvement in voice-related quality of life. CONCLUSION The voice assistance program with blended learning is effective for increasing knowledge about vocal health, reducing the risk of voice disorder and improving the voice quality of teachers.
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Lins CVDM, Maciel Martins JR, Kobayashi EY, Korn GP, Park SW, Mororó WC, De Biase NG. Hyaluronic Acid Concentration in Female Vocal Folds With Reinke's Edema. Otolaryngol Head Neck Surg 2021; 166:337-342. [PMID: 34000904 DOI: 10.1177/01945998211008914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of the present study was to investigate hyaluronic acid (HA) concentrations in vocal folds among patients with Reinke's edema. STUDY DESIGN Prospective and experimental study. SETTING Single tertiary center. METHODS An HA binding protein isolated from bovine nasal cartilage was used to identify and isolate the HA from samples. Plates coated with biotin-conjugated binding protein and streptavidin-europium conjugate were sequentially incubated with 18 Reinke's edema samples and 11 female vocal fold cover samples from cadavers (the superficial layer of the lamina propria; control group). After the release of europium from streptavidin in enhancement solution, final fluorescence was measured in a fluorometer. RESULTS The mean HA concentration in Reinke's edema vocal folds was significantly higher than that in the control vocal folds (9.2 × 103 vs 0.9 × 103µg/g). CONCLUSION Vocal fold covers affected by Reinke's edema present a higher concentration of HA than do vocal fold covers with no edema.
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Affiliation(s)
- Cristiana Vanderlei de Melo Lins
- Department of Otorhinolaryngology-Head and Neck Surgery, Universidade Federal de São Paulo / Escola Paulista de Medicina, São Paulo, Brazil
| | - João Roberto Maciel Martins
- Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Universidade Federal de São Paulo / Escola Paulista de Medicina, São Paulo, Brazil
| | - Elsa Yoko Kobayashi
- Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Universidade Federal de São Paulo / Escola Paulista de Medicina, São Paulo, Brazil
| | - Gustavo Polacow Korn
- Department of Otorhinolaryngology-Head and Neck Surgery, Universidade Federal de São Paulo / Escola Paulista de Medicina, São Paulo, Brazil
| | - Sung Woo Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Universidade Federal de São Paulo / Escola Paulista de Medicina, São Paulo, Brazil
| | - Welber Chaves Mororó
- Department of Otorhinolaryngology-Head and Neck Surgery, Universidade Federal de São Paulo / Escola Paulista de Medicina, São Paulo, Brazil.,Hospital Universitário da Universidade Federal do Maranhão, São Luís, Brazil
| | - Noemi Grigoletto De Biase
- Department of Otorhinolaryngology-Head and Neck Surgery, Universidade Federal de São Paulo / Escola Paulista de Medicina, São Paulo, Brazil.,Pontifícia Universidade Católica de São Paulo, São Paulo, Brazil
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[Molecular laryngology : A new chapter in the understanding of laryngeal diseases]. HNO 2021; 69:695-704. [PMID: 33822268 PMCID: PMC8413179 DOI: 10.1007/s00106-021-01016-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND Despite considerable advances in laryngological research, there is still a plethora of (benign) vocal fold pathologies that cannot be treated causally. This is due to the limited accessibility and sensitive microarchitecture of the vocal folds, which cannot be investigated at a cellular level. Consequently, current pathophysiological knowledge is frequently based on macroscopic findings. The impact of interventions is mainly evaluated endoscopically or via indirect diagnostic methods. OBJECTIVE The aim of this article is to discuss state-of-the-art biotechnological methods used in laryngological research, illustrated by practical examples. RESULTS In recent years, animal and in vitro experiments have significantly contributed to a continuous expansion of knowledge in this field, particularly regarding vocal fold inflammation and scar formation. Vocal fold fibroblasts, the most important cellular component of the lamina propria, can be accredited a central role in these processes. CONCLUSION Our knowledge regarding macroanatomy and macropathophysiology of several pathologies has increased considerably in recent years. In vitro trials have shown, e.g., that vocal fold fibroblasts in an inflammatory setting secrete less profibrotic and proinflammatory cytokines when exposed to vibration. Early vocal exercises after surgical interventions on the vocal folds may therefore promote better wound healing and consequently improved phonation. Research in molecular laryngology should create a solid basis of knowledge for subsequent clinical studies.
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Knickerbocker K, Bryan C, Ziegler A. Phonogenic Voice Problems among Speech-Language Pathologists in Synchronous Telepractice: An Overview and Recommendations. Semin Speech Lang 2021; 42:73-84. [PMID: 33596606 DOI: 10.1055/s-0040-1722754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Many speech-language pathologists (SLPs) recently adopted a live, synchronous online distribution of clinical services due to physical distancing measures aimed at bringing the coronavirus disease 2019 (COVID-19) outbreak under control. Few SLPs had received training in telepractice to prepare them for changes from an in-person service delivery model to synchronous telepractice. The new telepractice environment may alter vocal behaviors and communication interactions in such a way that negatively impacts voice production. Thus, delivering synchronous online clinical services may require that SLPs adopt novel prevention strategies for avoiding phonogenic voice problems. Guided by two complementary injury frameworks, the Haddon Matrix and the Haddon Countermeasures, this article provides an overview of potential factors associated with phonogenic voice problems among SLPs in telepractice and proposes possible prevention strategies to maintain optimal vocal health and function with synchronous modes of online clinical practice.
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Affiliation(s)
| | | | - Aaron Ziegler
- The Wellness Group for Voice, Speech, and Swallowing, LLC
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James BD, Guerin P, Allen JB. Let's Talk About Sex-Biological Sex Is Underreported in Biomaterial Studies. Adv Healthc Mater 2021; 10:e2001034. [PMID: 33043626 PMCID: PMC7791002 DOI: 10.1002/adhm.202001034] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/26/2020] [Indexed: 12/13/2022]
Abstract
Precision medicine aims to better individualize healthcare. It requires that biomaterials be designed for the physiological characteristics of a specific patient. To make this a reality, biomaterials research and development must address differences of biological sex. More specifically, biomaterials should be designed with properties optimized and appropriate for male and female patients. In analyzing research articles from seven prominent biomaterials journals, sex as a biological variable is missing from an overwhelming majority of in vitro biomaterial studies. From the survey, the reporting of the sex of primary cell cultures happened only 10.3% of the time. Contributing to this trend is that commercial vendors bias cell lines toward one sex or another by not disclosing information of cell line sex at the time of purchase; researchers do not communicate this pertinent information in published studies; and many journal policies have little to no requirements for reporting cell line characteristics. Omitting this valuable information leads to a gap in the understanding of sex-specific cell-biomaterial interactions and it creates a bias in research findings towards one sex or another. To curb this concerning trend and make precision biomaterials a reality will require the biomaterials field to "talk about sex" by reporting cell sex more broadly.
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Affiliation(s)
- Bryan D James
- Department of Materials Science and Engineering, University of Florida, 206 Rhines Hall, PO Box 116400, Gainesville, FL, 32611-6400, USA
| | - Paxton Guerin
- Department of Materials Science and Engineering, University of Florida, 206 Rhines Hall, PO Box 116400, Gainesville, FL, 32611-6400, USA
| | - Josephine B Allen
- Department of Materials Science and Engineering, University of Florida, 206 Rhines Hall, PO Box 116400, Gainesville, FL, 32611-6400, USA
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Costa MB, Ledo TO, Fernandes MD, Tiago RSL. The Importance of Inspiratory Maneuver for Benign Laryngeal Lesions. Int Arch Otorhinolaryngol 2020; 24:e513-e517. [PMID: 33101520 PMCID: PMC7575373 DOI: 10.1055/s-0040-1702968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 07/18/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction
Inspiratory maneuver corresponds to a simple method used during videolaryngoscopy to increase characterizations of laryngeal findings, through the movement of the vocal fold cover and exposure of the ligament, facilitating its evaluation.
Objective
To evaluate the increase in diagnosis of benign laryngeal lesions from the usage of inspiratory maneuvers during videolaryngoscopy in patients with or without vocal complaints.
Methods
A cross-sectional study performed from March 1 to July 1, 2018, in the Laryngology sector of a tertiary hospital. The age of the patients varied from 18 to 60 years old. They were divided into two groups, symptomatic and asymptomatic vocals, and evaluated through videolaryngoscopy together with inspiratory maneuvers. The exams were recorded and later evaluated by three trained laryngologists who determined the laryngeal lesions before and after the inspiratory maneuver.
Results
There were 60 patients in this sample, 41 of which were vocal symptomatic and 19 asymptomatic. The majority was female and the main complaint was about dysphonia. Before the inspiratory maneuver, the most observed lesions in both groups were chronic laryngitis, followed by vascular dysgenesis. After the inspiratory maneuver, sulcus vocalis was the most frequent additional finding.
Conclusion
With the inspiratory maneuver, it was possible to increase the identification of structural lesions in the vocal fold, and the most frequent lesion in patients with or without vocal complaints was sulcus vocalis.
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Affiliation(s)
- Marília Batista Costa
- Otorhinolaryngology Department, Hospital do Servidor Publico Estadual de Sao Paulo, Sao Paulo, SP, Brazil
| | - Taynara Oliveira Ledo
- Otorhinolaryngology Department, Hospital do Servidor Publico Estadual de Sao Paulo, Sao Paulo, SP, Brazil
| | - Mariana Delgado Fernandes
- Otorhinolaryngology Department, Hospital do Servidor Publico Estadual de Sao Paulo, Sao Paulo, SP, Brazil
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Ban MJ, Lee SC, Park JH, Park KN, Kim HK, Lee SW. Regenerative efficacy of fibroblast growth factor for the treatment of aged vocal fold: From animal model to clinical application. Clin Otolaryngol 2020; 46:131-137. [PMID: 32558170 DOI: 10.1111/coa.13597] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/03/2020] [Accepted: 06/04/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVES We assessed fibroblast growth factor (FGF) regenerative efficacy in an aged vocal fold rat model and confirmed it in a prospective clinical trial. DESIGN, SETTING, AND PARTICIPANTS For animal experiments, 48 Sprague-Dawley rats were divided into two groups: 24 six-month-olds (young group) and 24 twenty-four-month-olds (old group). FGF was injected once a week thrice into the left vocal fold of the old group, dividing them into two sub-groups (injected [left] and uninjected [right]). Additionally, we conducted a prospective clinical trial for 38 patients with aged atrophic vocal fold. MAIN OUTCOME MEASURES A month post-injection, excised larynx from the three groups was subjected to comparative histopathological (ratio of relative lamina propria to total vocal fold) and mRNA expression analysis (of procollagen I, hyaluronic acid synthase (HAS)-2 and matrix metalloproteinase (MMP)-2) by real-time PCR. We performed perceptual, stroboscopic, acoustic aerodynamic test and Voice Handicap Index survey prior to and 1, 6 and 12 months after FGF injection. RESULTS In rats, the relative lamina propria ratio increased after FGF injection. Procollagen I mRNA level decreased, whereas that of HAS-2 and MMP-2 increased significantly in the injected compared to the uninjected old group. Enrolled patients showed improved subjective and objective voice parameters after FGF injection, and these were maintained for a year. Potential side effects were not observed. CONCLUSIONS Animal experiments and prospective clinical trial suggest that FGF injection to vocal fold can significantly improve voice quality until one year, without complications, and is effective for aged atrophic vocal fold treatment.
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Affiliation(s)
- Myung Jin Ban
- Department of Otorhinolaryngology - Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Seung Chul Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Jae Hong Park
- Department of Otorhinolaryngology - Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Ki Nam Park
- Department of Otorhinolaryngology - Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Hee Kyung Kim
- Department of Pathology, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Seung Won Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea
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McCrary MW, Bousalis D, Mobini S, Song YH, Schmidt CE. Decellularized tissues as platforms for in vitro modeling of healthy and diseased tissues. Acta Biomater 2020; 111:1-19. [PMID: 32464269 DOI: 10.1016/j.actbio.2020.05.031] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 12/13/2022]
Abstract
Biomedical engineers are at the forefront of developing novel treatments to improve human health, however, many products fail to translate to clinical implementation. In vivo pre-clinical animal models, although the current best approximation of complex disease conditions, are limited by reproducibility, ethical concerns, and poor accurate prediction of human response. Hence, there is a need to develop physiologically relevant, low cost, scalable, and reproducible in vitro platforms to provide reliable means for testing drugs, biomaterials, and tissue engineered products for successful clinical translation. One emerging approach of developing physiologically relevant in vitro models utilizes decellularized tissues/organs as biomaterial platforms for 2D and 3D models of healthy and diseased tissue. Decellularization is a process that removes cellular content and produces tissue-specific extracellular matrix scaffolds that can more accurately recapitulate an organ/tissue's native microenvironment compared to other natural or synthetic materials. Decellularized tissues hold enormous potential for in vitro modeling of various disease phenotypes and tissue responses to drugs or external conditions such as aging, toxin exposure, or even implantation. In this review, we highlight the need for in vitro models, the advantages and limitations of implementing decellularized tissues, and considerations of the decellularization process. We discuss current research efforts towards applying decellularized tissues as platforms to generate in vitro models of healthy and diseased tissues, and where we foresee the field progressing. A variety of organs/tissues are discussed, including brain, heart, kidney, large intestine, liver, lung, skeletal muscle, skin, and tongue. STATEMENT OF SIGNIFICANCE: Many biomedical products fail to reach clinical translation due to animal model limitations. Development of physiologically relevant in vitro models can provide a more economic, scalable, and reproducible means of testing drugs/therapeutics for successful clinical translation. The use of decellularized tissues as platforms for in vitro models holds promise, as these scaffolds can effectively replicate native tissue complexity, but is not widely explored. This review discusses the need for in vitro models, the promise of decellularized tissues as biomaterial substrates, and the current research applying decellularized tissues towards the creation of in vitro models. Further, this review provides insights into the current limitations and future of such in vitro models.
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Affiliation(s)
- Michaela W McCrary
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, 1275 Center Dr. BMS J257, Gainesville, FL 32611, United States.
| | - Deanna Bousalis
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, 1275 Center Dr. BMS J257, Gainesville, FL 32611, United States.
| | - Sahba Mobini
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, 1275 Center Dr. BMS J257, Gainesville, FL 32611, United States; Instituto de Micro y Nanotechnología, IMN-CNM, CSIC (CEI UAM+CSIC), Calle Isaac Newton 8, 28760 Madrid, Tres Cantos, Spain; Departamento de Biología Molecular and Centro de Biología Molecular, Universidad Autónoma de Madrid, Calle Nicolás Cabrera, 28049 Madrid, Spain.
| | - Young Hye Song
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, 1275 Center Dr. BMS J257, Gainesville, FL 32611, United States; Department of Biomedical Engineering, University of Arkansas, 134 White Hall, Fayetteville, AR 72701, United States.
| | - Christine E Schmidt
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, 1275 Center Dr. BMS J257, Gainesville, FL 32611, United States.
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Management of presbyphonia: A systematic review of the efficacy of surgical intervention. Am J Otolaryngol 2020; 41:102532. [PMID: 32409162 DOI: 10.1016/j.amjoto.2020.102532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 04/29/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aging larynx undergoes structural changes that have functional consequences for voice production known as presbyphonia. Treatment of presbyphonia includes voice therapy and surgery. This review seeks to examine voice outcomes after surgery for presbyphonia. DATA SOURCES Three electronic databases (PreMed, ScienceDirect, Embase) were reviewed for articles published between 1 January 1900 and 1 June 2019. REVIEW METHODS Original English-language studies examining surgical treatment of presbyphonia in elderly patients (≥65 years) were included according to PRISMA. Two researchers independently analyzed articles. Outcome measures were extracted from and qualitatively compared across studies. RESULTS Of the 118 articles identified, five satisfied eligibility criteria. In all studies, diagnosis of presbyphonia was based on videostroboscopy. 85 patients (61M, 21F) were evaluated. 37.6% underwent implantation thyroplasty (IT), 48.2% underwent injection augmentation (IA), 7.1% underwent both, and 7.1% underwent basic-fibroblastic growth factor (b-FGF) injection. Average patient age was 71.3 years. Average follow-up time was 5.4 months. Three months post-intervention, IT patients self-reported greater improvement in quality of life (QoL) metrics compared to IA patients. Aerodynamic measures, like mean phonation time, were significantly improved in IT and IA, but not b-FGF-injected patients. All patients experienced improvements in the auditory perception of voice three months post-intervention. CONCLUSION Surgical modalities currently utilized for presbyphonia include IT and IA, with bFGF-injection being trialed abroad. IT patients reported enhanced QoL relative to IA and bFGF-injected patients. Overall there is a paucity of high-power, prospective studies that explore the efficacy of these modalities. Moreover, wide variability exists in reported outcomes among published studies.
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Alarouj H, Althekerallah JM, AlAli H, Ebrahim MA, Ebrahim MAK. A Comparative Study Utilizing the Voice Handicap Index-10 (VHI-10) in Teachers and the General Population of Kuwait. J Voice 2020; 36:289.e1-289.e10. [PMID: 32576523 DOI: 10.1016/j.jvoice.2020.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/10/2020] [Accepted: 05/18/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The objective of this study was to determine the prevalence of voice handicap perception of teachers in Kuwait and compare them within the general population by using the validated Arabic version of the voice handicap index-10 (VHI-10). Moreover, we explored variations within the teaching profession itself with regards to specific characteristics. METHODS The study was a cross-sectional survey design, in which participants from all governates of Kuwait (1820 teachers and 755 controls) completed the validated Arabic VHI-10, health-related, and demographic questions. The questionnaires were distributed among a random sample of elementary, middle, and high school teachers of both genders, and a random sample of the control population. RESULTS The mean VHI-10 of teachers was significantly higher than nonteachers (mean VHI-10 of teachers = 5.7, mean VHI-10 of nonteachers = 3.7, P < 0.001). Furthermore, there was a significant difference between teachers and controls in those who scored >11 in the VHI-10 (>11 = 17.6%, 10.2% respectively, P = <0.001). Female teachers scored a higher mean VHI-10 than male teachers (B = 0.66, P < 0.001). There was no difference in the mean VHI-10 among the different teaching class levels. However, elementary school teachers were the most group to exceed the cut-off point (VHI-10 >11) (Odds Ratio = 1.38, P = 0.04). With regards to smoking, we found no difference in the mean VHI-10 and scoring >11 in the questionnaire. Art and science teachers had the highest mean VHI-10 (P = 0.005 and 0.03, respectively). CONCLUSION The results of the study revealed a higher perception of voice handicap in teachers than nonteachers. Therefore, emphasis should be on teachers in order to prevent voice damage.
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Affiliation(s)
- Hamoud Alarouj
- ENT department, Farwaniya Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Jasem M Althekerallah
- Internal Medicine Department, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Hussain AlAli
- General Surgery Department, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Mohammad A Ebrahim
- General Surgery Department, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Mahmoud A K Ebrahim
- ENT department, Farwaniya Hospital, Ministry of Health, Kuwait City, Kuwait.
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Plexico LW, Sandage MJ, Kluess HA, Franco-Watkins AM, Neidert LE. Blood Plasma Hormone-Level Influence on Vocal Function. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:1376-1386. [PMID: 32402220 PMCID: PMC7842117 DOI: 10.1044/2020_jslhr-19-00224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 11/26/2019] [Accepted: 01/31/2020] [Indexed: 05/27/2023]
Abstract
Purpose This preliminary study examined the influence of menstrual cycle phase and hormone levels on acoustic measurements of vocal function in reproductive and postmenopausal females. Mean fundamental frequency (f0), speaking fundamental frequency (Sf0), and cepstral peak prominence (CPP) were evaluated. It was hypothesized that Sf0 and CPP would be lower during the luteal and ischemic phases of the menstrual cycle. Group differences with lower values in postmenopausal females and greater variability in the reproductive females were also hypothesized. Method A mixed factorial analysis of variance was used to examine differences between reproductive and postmenopausal females and the four phases of the menstrual cycle. Separate analyses of variances were implemented for each of the dependent measures. Twenty-eight female participants (15 reproductive cycling, 13 postmenopausal) completed the study. Participants were recorded reading the Rainbow Passage and sustaining the vowel /a/. Mean vocal f0, Sf0, and CPP were determined from the acoustic samples. Blood assays were used to determine estrogen, progesterone, testosterone, and neuropeptide Y levels at four data collection time points. Results Group differences in hormone levels and Sf0 values were established with the postmenopausal group having significantly lower hormone levels and significantly lower Sf0 than the reproductive cycling group across the phases. Analysis of the reproductive group by hormone levels and cycle phase revealed no significant differences for CPP or Sf0 across phases. Higher estrogen was identified in the ovulation phase, and higher progesterone was identified in the luteal phase. Conclusions Significant differences in hormone levels and Sf0 were identified between groups. Within the reproductive cycling group, the lack of significant difference in acoustic measures relative to hormone levels indicated that the measures taken may not have been sensitive enough to identify hormonally mediated vocal function changes. The participant selection may have biased the findings in that health conditions and medications that are known to influence voice function were used as exclusion criteria.
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Jesus MTAD, Ferrite S, Araújo TMD, Masson MLV. Distúrbio de voz relacionado ao trabalho: revisão integrativa. REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2020. [DOI: 10.1590/2317-6369000040218] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivos: identificar e sumarizar evidências de estudos sobre a associação entre trabalho e distúrbio de voz. Métodos: revisão integrativa da literatura publicada nas bases de dados PubMed e SciELO entre 2003 e 2017. Foram elegíveis estudos observacionais, em português ou inglês, disponíveis na íntegra para consulta, que abordassem a frequência de disfonia (prevalência ou incidência). Resultados: foram analisados 47 artigos, a idade media sumarizada dos participantes era de 40,6 anos, 78,7% dos artigos estudaram ambos os sexos e 80,9% pesquisaram professores. A prevalência média de distúrbios da voz associados ao trabalho foi de 44,2% e a incidência de 17,0%. O ruído foi indicado como fator associado à disfonia em 25,5% dos estudos, seguido da carga horária de trabalho extensa (17,0%) e alergias (14,9%). Conclusão: os resultados indicam forte conexão entre distúrbio de voz e trabalho, confirmando a elevada prevalência de disfonia, especialmente em trabalhadores que utilizam a voz profissionalmente, bem como sua associação com fatores da organização e do ambiente de trabalho, contribuindo para: a) fortalecer o reconhecimento formal do distúrbio de voz relacionado ao trabalho; b) oferecer embasamento técnico à legislação; c) reforçar a premência de uma política pública para proteção vocal dos trabalhadores.
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Kim JM, Heo HS, Shin SC, Kwon HK, Lee JC, Sung ES, Kim HS, Park GC, Lee BJ. Increased calcium channel in the lamina propria of aging rat. Aging (Albany NY) 2019; 11:8810-8824. [PMID: 31682233 PMCID: PMC6834399 DOI: 10.18632/aging.102284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 09/05/2019] [Indexed: 11/26/2022]
Abstract
The alterations of the extracellular matrix (ECM) in lamina propria of the vocal folds are important changes that are associated with decreased vibrations and increased stiffness in aging vocal fold. The aim of this study was to investigate the differences in gene expression of lamina propria using next generation sequencing (NGS) in young and aging rats and to identify genes that affect aging-related ECM changes for developing novel therapeutic target molecule. Among the 40 genes suggested in the NGS analysis, voltage-gated calcium channels (VGCC) subunit alpha1 S (CACNA1S), VGCC auxiliary subunit beta 1 (CACNB1), and VGCC auxiliary subunit gamma 1 (CACNG1) were increased in the lamina propria of the old rats compared to the young rats. The synthesis of collagen I and III in hVFFs decreased after si-CACNA1S and verapamil treatment. The expression and activity of matrix metalloproteinases (MMP)-1 and -8 were increased in hVFFs after the treatment of verapamil. However, there was no change in the expression of MMP-2 and -9. These results suggest that some calcium channels may be related with the alteration of aging-related ECM in vocal folds. Calcium channel has promising potential as a novel therapeutic target for the remodeling ECM of aging lamina propria.
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Affiliation(s)
- Ji Min Kim
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hyoung-Sam Heo
- Division of Bio-Medical Informatics, Center for Genome Science, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, Republic of Korea
| | - Sung-Chan Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Hyun-Keun Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Jin-Choon Lee
- , Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Eui-Suk Sung
- , Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Hyung-Sik Kim
- Department of Life Science in Dentistry, school of Dentistry, Pusan National University, Yangsan, Republic of Korea.,Institute for Translational Dental Science, Pusan National University, Yangsan, Republic of Korea
| | - Gi Cheol Park
- Department of Otolaryngology-Head and Neck Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Byung-Joo Lee
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University, Busan, Republic of Korea
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Silva CR, Babo PS, Mithieux S, Domingues RM, Reis R, Gomes ME, Weiss A. Tuneable cellulose nanocrystal and tropoelastin-laden hyaluronic acid hydrogels. J Biomater Appl 2019; 34:560-572. [PMID: 31284811 DOI: 10.1177/0885328219859830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Cristiana R Silva
- 1 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal.,2 ICVS/3B's - PT Government Associate Laboratory, Guimarães, Portugal
| | - Pedro S Babo
- 1 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal.,2 ICVS/3B's - PT Government Associate Laboratory, Guimarães, Portugal
| | - Suzanne Mithieux
- 3 Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia.,4 School of Molecular Bioscience, The University of Sydney, Sydney, New South Wales, Australia
| | - Rui Ma Domingues
- 1 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal.,2 ICVS/3B's - PT Government Associate Laboratory, Guimarães, Portugal.,5 The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Guimarães, Portugal
| | - Rui Reis
- 1 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal.,2 ICVS/3B's - PT Government Associate Laboratory, Guimarães, Portugal.,5 The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Guimarães, Portugal
| | - Manuela E Gomes
- 1 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal.,2 ICVS/3B's - PT Government Associate Laboratory, Guimarães, Portugal.,5 The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Guimarães, Portugal
| | - Anthony Weiss
- 3 Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia.,4 School of Molecular Bioscience, The University of Sydney, Sydney, New South Wales, Australia.,6 Bosch Institute, The University of Sydney, Sydney, New South Wales, Australia
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Hamdan AL, Khalifee E. Adverse Reaction to Restylane: A Review of 63 Cases of Injection Laryngoplasty. EAR, NOSE & THROAT JOURNAL 2019; 98:212-216. [PMID: 30913914 DOI: 10.1177/0145561319835773] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study is to review the prevalence of adverse reactions to cross-linked hyaluronic acid (HA) following injection laryngoplasty and discuss possible mechanisms. A retrospective chart review of patients who underwent injection laryngoplasty using HA was conducted. Demographic data included age, gender, etiology, site of injection, and amount injected. Adverse reaction was diagnosed by the presence of inflammatory reaction at the injection site. A total of 63 patients were included, divided into 41 males and 22 females with a mean age of 51.76 years. The most common etiology was vocal cord paralysis (n = 53), followed by postcordectomy, puberphonia, and vocal fold atrophy and bowing. The average amount injected was 0.56 (0.22) mL. Three cases out of 63 patients developed an adverse reaction and presented with airway symptoms, namely, progressive shortness of breath and globus 2 to 3 days postinjection. Adverse reactions following HA injection laryngoplasty may occur with life-threatening symptoms.
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Affiliation(s)
- Abdul-Latif Hamdan
- 1 Department of Otolaryngology and Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Elie Khalifee
- 1 Department of Otolaryngology and Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
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Lai YT, Wang YH, Yen YC, Yu TY, Chao PZ, Lee FP, Dailey S. The Epidemiology of Benign Voice Disorders in Taiwan: A Nationwide Population-Based Study. Ann Otol Rhinol Laryngol 2019; 128:406-412. [PMID: 30734582 DOI: 10.1177/0003489419826136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Because there are few population-based studies regarding the epidemiology of benign voice diseases, the present study used a nationwide population-based claims database (the National Health Insurance Research Database) to investigate the epidemiology of benign voice diseases among the general adult population in Taiwan. METHODS Study participants were retrieved for those patients who were 20 to 90 years old with a diagnosis of benign voice diseases that were defined by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes from 2006 to 2014. Patient visits were grouped into infectious (ICD-9-CM: 012.3, 032.3, 034.0, 090.5, 095.8,101, 464.0, 464.20, 464.21, 465.x, 476.0, 476.1) and noninfectious (ICD-9-CM: 306.1, 478.3x, 478.4, 478.5, 748.3, 784.4x) dysphonia groups. RESULTS Benign voice disorders have a prevalence of approximately 3.6% in Taiwan as of 2014. The year-to-year prevalence decreased gradually in the query period. Infectious dysphonia diagnoses were higher than noninfectious ones. Dysphonia caused by noninfectious diagnoses was most prevalent in the 60 to 79 years age group. Dysphonia caused by infectious diagnoses was highest in 20 to 39 years group. Noninfectious dysphonia diagnoses were more common in women. CONCLUSION The prevalence of voice disorders among the adult population in Taiwan was 3.6% in 2014. Voice disorders are more common in women and occur primarily in the 20 to 39 years age group. Infectious dysphonia is more common than noninfectious dysphonia. The results may be underestimated due to limitation of the database. This is the first population-based epidemiology study of adult voice disorders.
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Affiliation(s)
- Ying-Ta Lai
- 1 Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yuan-Hung Wang
- 2 Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,3 Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chun Yen
- 4 Research Center of Biostatistics, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Tzu-Yun Yu
- 4 Research Center of Biostatistics, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Pin-Zhir Chao
- 1 Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,3 Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Fei-Peng Lee
- 1 Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,3 Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,5 Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Seth Dailey
- 6 Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Amir O, Marroushi-Marrawi A, Primov-Fever A, Freud D. The Prevalence of Self-Reported Voice Disorders in Israel. J Voice 2018; 34:426-434. [PMID: 30527968 DOI: 10.1016/j.jvoice.2018.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Data on the prevalence of voice disorders is vital in order to describe and understand the phenomenon. The aim of this study was to estimate the prevalence of voice disorders in Israel, and perform a preliminary comparison between the two major societies in the country. METHODS A sample of 1146 people participated in a survey on voice disorders. This sample comprised 510 Israeli Jews and 627 Israeli Arabs. Each participant completed a questionnaire concerned with voice and its disorders as well as the shortened Voice Handicap Index-10 (VHI-10). RESULTS The overall prevalence of voice disorders within our sample was 13.90%. In addition, 30.26% of the participants reported experiencing a voice problem over the last year, while 12.81% reported seeing a physician for that reason. No significant differences were found in the prevalence of voice disorders between participants who identified themselves as either Jews or Arabs. A higher prevalence of voice disorders was found in the older age groups, and among people who reside in the southern region of the country. In contrast, no significant differences in the prevalence of reported voice disorders were found between men and women. CONCLUSION The prevalence of reported voice disorders in Israel is comparable with previous prevalence reports from other regions and societies. Data show that despite cultural, religion, language, and other factors, the prevalence of voice disorder among Israeli Jews and Arabs is very similar.
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Affiliation(s)
- Ofer Amir
- Department of Communication Disorders, The Stanley Steyer School of Health Professions, Tel-Aviv University, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Arij Marroushi-Marrawi
- Department of Communication Disorders, The Stanley Steyer School of Health Professions, Tel-Aviv University, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Adi Primov-Fever
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel
| | - Debora Freud
- Department of Communication Disorders, The Stanley Steyer School of Health Professions, Tel-Aviv University, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Icht M, Zukerman G, Hershkovich S, Laor T, Heled Y, Fink N, Fostick L. The "Morning Voice": The Effect of 24 Hours of Sleep Deprivation on Vocal Parameters of Young Adults. J Voice 2018; 34:489.e1-489.e9. [PMID: 30527970 DOI: 10.1016/j.jvoice.2018.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 11/15/2018] [Accepted: 11/15/2018] [Indexed: 01/01/2023]
Abstract
Fatigue following sleep deprivation adversely affects various aspects of human performance. It also induces recognizable voice changes, but the literature is inconsistent regarding their nature. The current study used acoustical analyses to assess the effect of 24 hours of sleep deprivation on vocal parameters of young adults. Forty-seven participants (23 females and 24 males) were tested after nocturnal sleep and after 24 hours of sleep deprivation. Different voice samples were recorded (sustained phonation, words, and sentences) and analyzed for fundamental frequency (F0, in Hz), vocal intensity (in dB), harmonic-noise ratio (HNR, in dB), jitter, and shimmer (in %). The main finding was significantly higher HNR values following sleep deprivation than nocturnal sleep for females, across all voice samples. The HNR is a measure of the degree of acoustic periodicity, or the amount of noise compared to the harmonic quality present in the voice. As its values are higher, the voice quality is perceptually better. The current results indicate that females had a significantly higher ratio of vocal harmonics compared to vocal noise when they were sleep deprived. In contrast, following nocturnal sleep, the ratio of vocal harmonics compared to vocal noise was lower, which means the voice quality was poorer. This may explain the common perceptual impressions of decreased voice quality after sleep, which may be more pronounced in females.
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Affiliation(s)
- Michal Icht
- Department of Communication Disorders, Ariel University, Ariel, Israel.
| | - Gil Zukerman
- Department of Communication Disorders, Ariel University, Ariel, Israel
| | | | - Tal Laor
- School of Communication, Ariel University, Ariel, Israel
| | - Yuval Heled
- Heller Institute of Medical Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Nir Fink
- Department of Communication Disorders, Ariel University, Ariel, Israel; Israel Defense Forces, Medical Corps Hakirya, Tel-Aviv, Israel
| | - Leah Fostick
- Department of Communication Disorders, Ariel University, Ariel, Israel
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Comunoglu N, Kocak I, Saygi HI, Yener HM, Batur S, Demiray SB, Seckin I, Tanriover O, Comunoglu C. Dilated Minute Chambers in Laryngeal Vocal Fold Polyps: Histopathological and Ultrastructural Features. J Voice 2018; 34:289-293. [PMID: 30361131 DOI: 10.1016/j.jvoice.2018.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 11/18/2022]
Abstract
In Reinke's space of human vocal fold, type III collagen forms a three dimensional network and this contains numerous minute chambers in between these fibers. These compartments are occupied by glycosaminoglycans and glycoproteins. In laryngeal fold lesions, such as Reinke's edema and vocal fold polyps, proteoglycan (PG)/hyaluronic acid (HA) components of extracellular matrix increased. We investigated the size and quantity of the minute chambers within Reinke's space, filled with PG/HA with the aid of transmission electron microscopy. Eight vocal fold polyps and 10 mucosal biopsies (as control group) were all evaluated by light microscopy and electron microscopy. We detected that PG/HA in extracellular matrix had been increased in vocal fold lesions when compared with control group, by Alcian Blue-pH 2.5 stain. The mean volume of the chambers in Reinke's space of normal larynx was measured as 0.040233 µm2 whereas the mean volume of these chambers in vocal fold polyps was measured as 6.420221 µm2. The difference between the volumes of these chambers in vocal fold polyps and in control group was statistically significant (P = 0.001). Within these chambers PG/HA were found and PG/HA filling these chambers were increased in vocal fold polyps. We think proteoglycan and glycosaminoglycans, especially HA, play an important role in determining biochemical properties of vocal fold lesions.
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Affiliation(s)
- Nil Comunoglu
- Istanbul University, Cerrahpaşa Faculty of Medicine, Department of Pathology, Istanbul, Turkey.
| | - Ismail Kocak
- Okan University, Faculty of Medicine, Department of Otorhinolaryngology, Istanbul, Turkey
| | - Halil Ibrahim Saygi
- Istanbul University, Cerrahpaşa Faculty of Medicine, Department of Histology and Embryology, Istanbul, Turkey
| | - Haydar Murat Yener
- Istanbul University, Cerrahpaşa Faculty of Medicine, Department of Otorhinolaryngology, Istanbul, Turkey
| | - Sebnem Batur
- Istanbul University, Cerrahpaşa Faculty of Medicine, Department of Pathology, Istanbul, Turkey
| | - Sirin Bakti Demiray
- Istanbul University, Cerrahpaşa Faculty of Medicine, Department of Histology and Embryology, Istanbul, Turkey
| | - Ismail Seckin
- Istanbul University, Cerrahpaşa Faculty of Medicine, Department of Histology and Embryology, Istanbul, Turkey
| | - Ozlem Tanriover
- Yeditepe University, Faculty of Medicine, Department of Family Medicine, Istanbul, Turkey
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Lee SS, Kim HD, Kim SHL, Kim I, Kim IG, Choi JS, Jeong J, Kim JH, Kwon SK, Hwang NS. Self-Healing and Adhesive Artificial Tissue Implant for Voice Recovery. ACS APPLIED BIO MATERIALS 2018; 1:1134-1146. [DOI: 10.1021/acsabm.8b00349] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Seunghun S. Lee
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 08826, Republic of Korea
| | - Hwan D. Kim
- School of Chemical and Biological Engineering, The Institute of Chemical Processes, Seoul National University, Seoul 08826, Republic of Korea
| | - Seung Hyun L. Kim
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 08826, Republic of Korea
| | - Inseon Kim
- School of Chemical and Biological Engineering, The Institute of Chemical Processes, Seoul National University, Seoul 08826, Republic of Korea
| | - In Gul Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Ji Suk Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Jiwoon Jeong
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 08826, Republic of Korea
| | - Jung Hun Kim
- School of Chemical and Biological Engineering, The Institute of Chemical Processes, Seoul National University, Seoul 08826, Republic of Korea
| | - Seong Keun Kwon
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 08826, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Nathaniel S. Hwang
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 08826, Republic of Korea
- School of Chemical and Biological Engineering, The Institute of Chemical Processes, Seoul National University, Seoul 08826, Republic of Korea
- BioMAX/N-Bio Institute, Seoul National University, Seoul 08826, Republic of Korea
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Tsui SY, Tsao Y, Lin CW, Fang SH, Lin FC, Wang CT. Demographic and Symptomatic Features of Voice Disorders and Their Potential Application in Classification Using Machine Learning Algorithms. Folia Phoniatr Logop 2018; 70:174-182. [DOI: 10.1159/000492327] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 07/10/2018] [Indexed: 11/19/2022] Open
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Chan RW. Nonlinear viscoelastic characterization of human vocal fold tissues under large-amplitude oscillatory shear (LAOS). JOURNAL OF RHEOLOGY 2018; 62:695-712. [PMID: 29780189 PMCID: PMC5959278 DOI: 10.1122/1.4996320] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Viscoelastic shear properties of human vocal fold tissues were previously quantified by the shear moduli (G' and G″). Yet these small-strain linear measures were unable to describe any nonlinear tissue behavior. This study attempted to characterize the nonlinear viscoelastic response of the vocal fold lamina propria under large-amplitude oscillatory shear (LAOS) with a stress decomposition approach. Human vocal fold cover and vocal ligament specimens from eight subjects were subjected to LAOS rheometric testing with a simple-shear rheometer. The empirical total stress response was decomposed into elastic and viscous stress components, based on odd-integer harmonic decomposition approach with Fourier transform. Nonlinear viscoelastic measures derived from the decomposition were plotted in Pipkin space and as rheological fingerprints to observe the onset of nonlinearity and the type of nonlinear behavior. Results showed that both the vocal fold cover and the vocal ligament experienced intercycle strain softening, intracycle strain stiffening, as well as shear thinning both intercycle and intracycle. The vocal ligament appeared to demonstrate an earlier onset of nonlinearity at phonatory frequencies, and higher sensitivity to changes in frequency and strain. In summary, the stress decomposition approach provided much better insights into the nonlinear viscoelastic behavior of the vocal fold lamina propria than the traditional linear measures.
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Affiliation(s)
- Roger W Chan
- Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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Lechien JR, Huet K, Khalife M, Fourneau AF, Finck C, Delvaux V, Piccaluga M, Harmegnies B, Saussez S. Gender differences in the presentation of dysphonia related to laryngopharyngeal reflux disease: a case-control study. Eur Arch Otorhinolaryngol 2018; 275:1513-1524. [DOI: 10.1007/s00405-018-4951-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/22/2018] [Indexed: 12/31/2022]
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Affiliation(s)
- Cara Sauder
- Department of Speech and Hearing Sciences, University of Washington
Seattle, WA
| | - Albert L. Merati
- Department of Otolaryngology - Head & Neck Surgery, University of Washington School of Medicine
Seattle, WA
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Fuentes-López E, Fuente A, Contreras KV. Inadequate vocal hygiene habits associated with the presence of self-reported voice symptoms in telemarketers. LOGOP PHONIATR VOCO 2017; 44:105-114. [DOI: 10.1080/14015439.2017.1414302] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Eduardo Fuentes-López
- Programa de Doctorado en Salud Pública, Escuela de Salud Pública, Universidad de Chile, Santiago, Chile
- Carrera de Fonoaudiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Adrian Fuente
- École d’orthophonie et d’audiologie, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada
| | - Karem V. Contreras
- Escuela de Fonoaudiología, Facultad de Ciencias de la Salud, Universidad San Sebastian, Santiago, Chile
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