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Hamdan AL, Abi Zeid Daou C, Nawfal N, Lechien JR. Prevalence of Laryngopharyngeal Reflux Related Symptoms in Patients With Allergy. J Voice 2024; 38:754-759. [PMID: 35168866 DOI: 10.1016/j.jvoice.2021.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To describe the prevalence of laryngopharyngeal reflux (LPR)-related symptoms in allergy patient using the Reflux Symptom Index (RSI) by Belafsky et al and the Reflux Symptom Score (RSS) by Lechien et al. SUBJECTS AND METHODS: A total of 84 patients were enrolled in this study. Fifty-two consecutive patients were asked to fill RSI. Similarly, 32 patients were asked to fill RSS. Demographic data included age, gender, history of smoking, family history for eczema, atopy, asthma, food and drug allergy. RESULTS Fifty-seven of the 84 patients were positive for at least one allergen and hence were diagnosed with allergy. Of the 52 patients who received the RSI, 36 patients were allergic to at least one allergen (36/52). Of the 32 patients who filled the RSS, 21 tested positive for at least one allergen (21/32). There was no significant difference in the number of positive RSI scores (>13) between patients with allergy to at least one allergen in comparison to patients with no allergy (P = 0.329). There was a significant difference in the number of positive RSS scores (>13) between patients with allergy to at least one allergen in comparison to patients with no allergy (P-value 0.0345). The odds of having RSS >13 in an allergic patient was significant (OR = 5.6, CI 95% = 1.15-27.37). CONCLUSION The results of this study provide evidence that patients with allergy have increased incidence of LPR related symptoms using the RSS. The cross-cutting in the clinical picture of patients with allergy and LPR stresses the need for objective testing such as double probe Ph-metry and impedance to diagnose this latter. Future studies are needed to explore further the cause-effect relationship between allergy and LPR.
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Affiliation(s)
- Abdul Latif Hamdan
- American University of Beirut Medical Center, Department of Otolaryngology and Head & Neck Surgery, Beirut, Lebanon.
| | - Christophe Abi Zeid Daou
- American University of Beirut Medical Center, Department of Otolaryngology and Head & Neck Surgery, Beirut, Lebanon
| | - Nader Nawfal
- American University of Beirut Medical Center, Department of Otolaryngology and Head & Neck Surgery, Beirut, Lebanon
| | - Jerome R Lechien
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, University Paris Saclay, Paris, France
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Abstract
INTRODUCTION Office-based laser procedures in laryngology have gained a lot of popularity in the last decade with the use of the KTP, PDL and Thulium lasers. Preliminary investigations currently report on the use of the 445 nm wavelength Blue laser for the treatment of various laryngeal pathologies, given its dual photoangiolytic and cutting properties. OBJECTIVE We aim to investigate the safety and efficacy of the Blue laser for the treatment of vocal fold lesions. METHODS This is a retrospective chart review of eleven patients with a variety of vocal fold lesions (polyps, Reinke's edema, papilloma, and leukoplakia), that underwent un-sedated office-based treatment using the 445 nm blue laser. The primary outcome was to compare preoperative to postoperative Voice Handicap Index (VHI-10) score and self-reported voice improvement using a visual analog scale (VAS). We also compared fiberoptic laryngeal examination before and after treatment. RESULTS Eleven un-sedated office-based procedures using the blue laser were performed. There was improvement in the mean VHI-10 score (n = 8) with a decrease from 15.13 ± 8.77 to 3.50 ± 3.46 (P= 0.015). Similarly, the mean VAS score (n = 7) decreased from 6.14 ± 1.21 to 1.71 ± 1.60 (P< 0.003). All patients had a complete or partial regression of the vocal fold lesions on fiberoptic laryngeal examination. None of the patients had complications after the procedure. CONCLUSION Blue laser therapy can be suggested as a safe and effective alternative treatment modality in office-based laryngology procedures for a variety of vocal fold lesions. A larger series is needed to better validate the efficacy of this laser as a new treatment modality.
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Affiliation(s)
- Abdul Latif Hamdan
- Department of Otorhinolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Anthony Ghanem
- Department of Otorhinolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
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Ghanem A, Hamdan AL. Unsedated Office-Based Blue Laser Therapy in Female Patients With Reinke's Edema: A Retrospective Review of 8 Cases. J Voice 2022:S0892-1997(22)00266-1. [PMID: 36220740 DOI: 10.1016/j.jvoice.2022.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To report on the outcomes of unsedated blue laser therapy in female patients with Reinke's edema. STUDY DESIGN Retrospective chart review. METHODS A retrospective chart review of female patients undergoing unsedated office-based blue laser treatment of Reinke's edema between February 2020 and March 2022 at the Hamdan Voice and Swallowing Unit at the American University of Beirut Medical Center in Beirut, was conducted. Patients were assessed before and after the procedure with a follow-up interval of 3-6 weeks. Demographic data included age, history of smoking and grade of Reinke's edema. Voice outcome measures included the Voice Handicap Index-10 questionnaire, perceptual evaluation (GRBAS scale), acoustic analysis and maximum phonation time. Vocal fold lesions were evaluated using indirect laryngeal endoscopy. RESULTS A total of eight patients were reviewed. The mean age was 59.63 ± 7.98 years. One patient was lost to follow-up. We report on a total of 10 Reinke's edema lesions treated with the blue laser. There was a significant decrease in the mean VHI-10 score (14.86 ± 5.84-6.71 ± 7.32; P < 0.01) as well as in the means of three perceptual evaluation parameters (G, R, B; P < 0.05). There was also a nonstatistically significant increase in the mean fundamental frequency and habitual pitch. Laryngeal examination showed complete regression in 50% of the lesions, and partial regression in the remaining 50%. CONCLUSIONS Office-based blue laser treatment of Reinke's edema under local anesthesia can be considered an effective treatment modality as evidenced by improvement in post-procedure voice outcome measures.
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Affiliation(s)
- Anthony Ghanem
- Department of Otorhinolaryngology and Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Abdul Latif Hamdan
- Department of Otorhinolaryngology and Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
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Hamdan AL, Abi Zeid Daou C, Nawfal N, Karam M. Prevalence of Self-Reported Dysphonia and Dysphagia in Patients with Allergy. J Voice 2021:S0892-1997(21)00082-5. [PMID: 33824033 DOI: 10.1016/j.jvoice.2021.02.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/06/2021] [Accepted: 02/11/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the prevalence of self-reported dysphonia and dysphagia in patients with positive allergy test in comparison to patients with negative allergy tests. SUBJECTS AND METHODS A total of 52 patients who presented to the allergy clinic of a tertiary medical referral center for skin testing between June 2019 and December 2019 were were recruited for this study. Demographic data included age, gender, history of smoking, family history for eczema, atopy, asthma, food and drug allergy. A control group of 20 subjects was matched according to age and gender. All subjects were asked to fill the voice handicap index -10 and the eating assessment tool (EAT-10) questionnaires. RESULTS Thirty-six of 52 patients were positive for at least one allergen, and 23 tested positive for at least three allergens. On the other hand, there was no significant difference in the mean score of VHI-10 in patients with allergy to at least one allergen, in comparison to patients with no allergy (3.667 vs 3.066, respectively, P value 0.307). Similarly, there was no significant difference in the mean score of EAT-10 between the two groups (0.305 vs 0.00, respectively, P value 0.270). There was also no significant difference in the mean score of VHI-10 in patients with allergy to at least three allergens in comparison to patients with no allergy (3.304 vs 3.066, respectively, P-value 0.603). Similarly, there was no significant difference in the mean score of EAT-10 between the two groups (0.435 vs 0.00, respectively, P-value 0.667). There was a significant difference in mean VHI-10 scores between patients testing positive for at least one allergen and the control group (P = 0.0002). CONCLUSION The results of this investigation did not show any significance in the prevalence of self-reported dysphonia and dysphagia in patients with positive allergy skin testing in comparison to those with negative allergy skin-testing. More clinical studies on the prevalence of self-reported phonatory complaints in patients with allergy are warranted.
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Affiliation(s)
- Abdul Latif Hamdan
- Allergy & Clinical Immunology - Internal Medicine Department, American University of Beirut Medical Center, Beirut, Lebanon
| | - Christophe Abi Zeid Daou
- Allergy & Clinical Immunology - Internal Medicine Department, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nader Nawfal
- Allergy & Clinical Immunology - Internal Medicine Department, American University of Beirut Medical Center, Beirut, Lebanon
| | - Marilyn Karam
- Allergy & Clinical Immunology - Internal Medicine Department, American University of Beirut Medical Center, Beirut, Lebanon.
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Kim SI, Lechien JR, Ayad T, Jia H, Khoddami SM, Enver N, Raghunandhan SK, Hamdan AL, Eun YG. Management of Laryngopharyngeal Reflux in Asia. Clin Exp Otorhinolaryngol 2020; 13:299-307. [PMID: 32392640 PMCID: PMC7435427 DOI: 10.21053/ceo.2019.01669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 12/14/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES This study was conducted to investigate the current practices of Asian otolaryngologists for laryngopharyngeal reflux (LPR). METHODS An online survey about LPR was sent to 2,000 members of Asian otolaryngological societies, and a subgroup analysis was performed between Western and Eastern Asian otolaryngologists. The survey was conducted by the Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies. RESULTS Among approximately 1,600 Asian otolaryngologists, 146 completed the survey (62 from Western Asian countries, 84 from Eastern Asian countries). A substantial majority (73.3%) of the otolaryngologists considered LPR and gastroesophageal reflux disease to be different diseases. The symptoms thought to be closely related to LPR were coughing after lying down, throat clearing, and globus sensation. The findings thought to be closely related to LPR were posterior commissure granulations and hypertrophy, arytenoids, and laryngeal erythema. The respondents indicated that they mostly diagnosed LPR (70%) after an empirical therapeutic trial of proton pump inhibitors (PPIs). Although multichannel intraluminal impedance-pH (MII-pH) monitoring is a useful tool for diagnosing nonacid or mixed LPR, 78% of Asian otolaryngologists never or very rarely used MII-pH. Eastern Asian otolaryngologists more frequently used once-daily PPIs (64.3% vs. 45.2%, P=0.021), whereas Western Asian otolaryngologists preferred to use twice-daily PPIs (58.1% vs. 39.3%, P=0.025). The poor dietary habits of patients were considered to be the main reason for therapeutic failure by Asian otolaryngologists (53.8%). Only 48.6% of Asian otolaryngologists considered themselves to be adequately knowledgeable and skilled regarding LPR. CONCLUSION Significant differences exist between Western and Eastern Asian otolaryngologists in the diagnosis and treatment of LPR. Future consensus statements are needed to establish diagnostic criteria and therapeutic regimens.
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Affiliation(s)
- Su Il Kim
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France.,Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jerome R Lechien
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France.,Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Tareck Ayad
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France.,Division of Otolaryngology-Head and Neck Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada
| | - Huan Jia
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France.,Department of Otorhinolaryngology and Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Seyyedeh Maryam Khoddami
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France.,Larynx Function Laboratory, Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Necati Enver
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France.,Department of Otolaryngology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Sampath Kumar Raghunandhan
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France.,Department of Otology, Neurotology and Skullbase Surgery, Madras ENT Research Foundation, Chennai, India
| | - Abdul Latif Hamdan
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France.,Department of Otorhinolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Young-Gyu Eun
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France.,Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
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Lechien JR, Akst LM, Hamdan AL, Schindler A, Karkos PD, Barillari MR, Calvo-Henriquez C, Crevier-Buchman L, Finck C, Eun YG, Saussez S, Vaezi MF. Evaluation and Management of Laryngopharyngeal Reflux Disease: State of the Art Review. Otolaryngol Head Neck Surg 2019; 160:762-782. [PMID: 30744489 DOI: 10.1177/0194599819827488] [Citation(s) in RCA: 205] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To review the current literature about the epidemiology, clinical presentation, diagnosis, and treatment of laryngopharyngeal reflux (LPR). DATA SOURCES PubMed, Cochrane Library, and Scopus. METHODS A comprehensive review of the literature on LPR epidemiology, clinical presentation, diagnosis, and treatment was conducted. Using the PRISMA statement, 3 authors selected relevant publications to provide a critical analysis of the literature. CONCLUSIONS The important heterogeneity across studies in LPR diagnosis continues to make it difficult to summarize a single body of thought. Controversies persist concerning epidemiology, clinical presentation, diagnosis, and treatment. No recent epidemiologic study exists regarding prevalence and incidence with the use of objective diagnostic tools. There is no survey that evaluates the prevalence of symptoms and signs on a large number of patients with confirmed LPR. Regarding diagnosis, an increasing number of authors used multichannel intraluminal impedance-pH monitoring, although there is no consensus regarding standardization of the diagnostic criteria. The efficiency of proton pump inhibitor (PPI) therapy remains poorly demonstrated and misevaluated by incomplete clinical tools that do not take into consideration many symptoms and extralaryngeal findings. Despite the recent advances in knowledge about nonacid LPR, treatment protocols based on PPIs do not seem to have evolved. IMPLICATIONS FOR PRACTICE The development of multichannel intraluminal impedance-pH monitoring and pepsin and bile salt detection should be considered for the establishment of a multiparameter diagnostic approach. LPR treatment should evolve to a more personalized regimen, including diet, PPIs, alginate, and magaldrate according to individual patient characteristics. Multicenter international studies with a standardized protocol could improve scientific knowledge about LPR.
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Affiliation(s)
- Jerome R Lechien
- 1 Laryngopharyngeal Reflux Study Group of Young Otolaryngologists, International Federation of Oto-rhino-laryngological Societies, Paris, France.,2 Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium.,3 Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons, Mons, Belgium.,4 Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Faculty of Medicine, University Libre de Bruxelles, Brussels, Belgium
| | - Lee M Akst
- 5 Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Abdul Latif Hamdan
- 1 Laryngopharyngeal Reflux Study Group of Young Otolaryngologists, International Federation of Oto-rhino-laryngological Societies, Paris, France.,6 Department of Otorhinolaryngology and Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Antonio Schindler
- 1 Laryngopharyngeal Reflux Study Group of Young Otolaryngologists, International Federation of Oto-rhino-laryngological Societies, Paris, France.,7 Department of Biomedical and Clinical Sciences, Phoniatric Unit, L. Sacco Hospital, University of Milan, Milan, Italy
| | - Petros D Karkos
- 1 Laryngopharyngeal Reflux Study Group of Young Otolaryngologists, International Federation of Oto-rhino-laryngological Societies, Paris, France.,8 Department of Otorhinolaryngology and Head and Neck Surgery, Thessaloniki Medical School, Thessaloniki, Greece
| | - Maria Rosaria Barillari
- 1 Laryngopharyngeal Reflux Study Group of Young Otolaryngologists, International Federation of Oto-rhino-laryngological Societies, Paris, France.,9 Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Naples SUN, Naples, Italy
| | - Christian Calvo-Henriquez
- 1 Laryngopharyngeal Reflux Study Group of Young Otolaryngologists, International Federation of Oto-rhino-laryngological Societies, Paris, France.,10 Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Lise Crevier-Buchman
- 1 Laryngopharyngeal Reflux Study Group of Young Otolaryngologists, International Federation of Oto-rhino-laryngological Societies, Paris, France.,11 Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, Paris, France
| | - Camille Finck
- 1 Laryngopharyngeal Reflux Study Group of Young Otolaryngologists, International Federation of Oto-rhino-laryngological Societies, Paris, France.,2 Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium.,12 Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Liège, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Young-Gyu Eun
- 1 Laryngopharyngeal Reflux Study Group of Young Otolaryngologists, International Federation of Oto-rhino-laryngological Societies, Paris, France.,13 Department of Otorhinolaryngology and Head and Neck Surgery, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Sven Saussez
- 1 Laryngopharyngeal Reflux Study Group of Young Otolaryngologists, International Federation of Oto-rhino-laryngological Societies, Paris, France.,2 Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium.,4 Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Faculty of Medicine, University Libre de Bruxelles, Brussels, Belgium
| | - Michael F Vaezi
- 14 Division of Gastroenterology, Hepatology, Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Lechien JR, Saussez S, Schindler A, Karkos PD, Hamdan AL, Harmegnies B, De Marrez LG, Finck C, Journe F, Paesmans M, Vaezi MF. Clinical outcomes of laryngopharyngeal reflux treatment: A systematic review and meta-analysis. Laryngoscope 2018; 129:1174-1187. [PMID: 30597577 DOI: 10.1002/lary.27591] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/06/2018] [Accepted: 09/10/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To investigate the therapeutic benefit of proton pump inhibitors (PPIs) over placebo in patients with laryngopharyngeal reflux (LPR) and to analyze the epidemiological factors of heterogeneity in the literature. METHODS An electronic literature search was conducted to identify articles published between 1990 and 2018 about clinical trials describing the efficiency of medical treatment(s) on LPR. First, a meta-analysis of placebo randomized controlled trials (RCTs) comparing PPIs versus placebo was conducted according to diet. The heterogeneity, response to PPIs, and evolution of clinical scores were analyzed for aggregate results. Second, a systematic review of diagnosis methods, clinical outcome of treatment, and therapeutic regimens was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. RESULTS The search identified 1,140 relevant publications, of which 72 studies met the inclusion criteria for a total of 5,781 patients. Ten RCTs were included in the meta-analysis. The combined relative risk was 1.31 in favor of PPIs and increased to 1.42 when patients did not receive diet recommendations. Randomized controlled trials were characterized by a significant heterogeneity due to discrepancies in clinical therapeutic outcomes, diagnosis methods (lack of gold standard diagnostic tools), and therapeutic scheme. The epidemiological analysis of all articles supports the existence of these discrepancies in the entire literature. In particular, many symptoms and signs commonly encountered in LPR are not assessed in the treatment effectiveness. The lack of diagnosis precision and variability of inclusion criteria particularly create bias in all reported and included articles. CONCLUSION This meta-analysis supports a mild superiority of PPIs over placebo and the importance of diet as additional treatment but demonstrates the heterogeneity between studies, limiting the elaboration of clear conclusions. International recommendations are proposed for the development of future trials. Laryngoscope, 129:1174-1187, 2019.
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Affiliation(s)
- Jerome R Lechien
- From the Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS).,the Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology.,the Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons (UMons), Mons
| | - Sven Saussez
- From the Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS).,the Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology.,the Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles
| | - Antonio Schindler
- From the Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS).,the Department of Biomedical and Clinical Sciences, Phoniatric Unit, L. Sacco Hospital, University of Milan, Milan, Italy
| | - Petros D Karkos
- From the Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS).,the Department of Otorhinolaryngology and Head and Neck Surgery, Thessaloniki Medical School, Thessaloniki, Greece
| | - Abdul Latif Hamdan
- From the Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS).,the Department of Otorhinolaryngology and Head and Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Bernard Harmegnies
- From the Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS).,the Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons (UMons), Mons
| | - Lisa G De Marrez
- From the Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS).,the Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology
| | - Camille Finck
- From the Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS).,the Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Liège, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Fabrice Journe
- From the Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS).,the Laboratory of Anatomy and Cell Biology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology
| | - Marianne Paesmans
- the Information Management Unit, Institut Jules Bordet, Université Libre de Bruxelles, School of Medicine, Brussels
| | - Michael F Vaezi
- Division of Gastroenterology, Hepatology, Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A
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Ziade G, Semaan S, Assaad S, Hamdan AL. Age-related changes affecting the cricoarytenoid joint seen on computed tomography. Ear Nose Throat J 2018; 97:244-256. [PMID: 30138516 DOI: 10.1177/014556131809700821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We conducted a retrospective chart review to compare four characteristics-cricoarytenoid joint ankylosis, narrowing, erosion, and density increases-in patients younger and older than 65 years. Our study population was made up of 100 patients, who were divided into two groups on the basis of age. The younger group (<65 yr) comprised 49 patients (27 men and 22 women), and the older group (≥65 yr) was made up of 51 patients (25 men and 26 women). Findings on computed tomography (CT) of the neck were used to determine whether each of the four characteristics was present or absent. Overall, we found only one statistically significant difference between the two groups: ankylosis was significantly more common in the older group (p = 0.036). When we looked further at the side of these anatomic changes, we found that the older group had significantly more right-sided and left-sided ankylosis than did the younger group (p = 0.026 for both), as well as significantly more left-sided narrowing (p = 0.028) (some patients had bilateral involvement). When we analyzed age as a continuous variable, older age was again associated with significantly more ankylosis (p = 0.047) and narrowing (p = 0.011). We conclude that CT can be useful for assessing radiologic changes in the cricoarytenoid joint in elderly patients during the workup of dysphonia and abnormal movement of the vocal folds.
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Affiliation(s)
- Georges Ziade
- Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, PO Box 110236, Beirut, Lebanon
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Lechien JR, Hamdan AL, Saussez S. Laryngopharyngeal reflux and benign lesions of the vocal folds. Eur Arch Otorhinolaryngol 2018; 276:277-278. [PMID: 30465073 DOI: 10.1007/s00405-018-5217-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 11/16/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Jerome R Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium. .,Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons (UMons), Mons, Belgium. .,Department of Otorhinolaryngology and Head and Neck Surgery, School of Medicine, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.
| | - Abdul Latif Hamdan
- Department of Otorhinolaryngology and Head and Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Sven Saussez
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, School of Medicine, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
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Lechien JR, Schindler A, De Marrez LG, Hamdan AL, Karkos PD, Harmegnies B, Barillari MR, Finck C, Saussez S. Instruments evaluating the clinical findings of laryngopharyngeal reflux: A systematic review. Laryngoscope 2018; 129:720-736. [DOI: 10.1002/lary.27537] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Jerome R. Lechien
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS); Mons
- Department of Anatomy and Experimental Oncology; Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology; Mons
- Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology ; University of Mons (UMons); Mons
| | - Antonio Schindler
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS); Mons
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, School of Medicine; Université Libre de Bruxelles; Brussels
| | - Lisa G. De Marrez
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS); Mons
| | - Abdul Latif Hamdan
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Liège, Faculty of Medicine; University of Liège; Liège Belgium
| | - Petros D. Karkos
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS); Mons
- Department of Biomedical and Clinical Sciences, Phoniatric Unit, L. Sacco Hospital; University of Milan; Milan
| | - Bernard Harmegnies
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS); Mons
- Department of Anatomy and Experimental Oncology; Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology; Mons
| | - Maria Rosaria Barillari
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS); Mons
- Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine; University of Naples SUN; Naples Italy
- Department of Otorhinolaryngology and Head and Neck Surgery; Thessaloniki Medical School; Thessaloniki Greece
| | - Camille Finck
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS); Mons
- Department of Anatomy and Experimental Oncology; Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology; Mons
- Department of Otorhinolaryngology and Head and Neck Surgery; American University of Beirut-Medical Center; Beirut Lebanon
| | - Sven Saussez
- Laryngopharyngeal Reflux Study Group of Young Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS); Mons
- Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology ; University of Mons (UMons); Mons
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Hamdan AL, Rizk M, Ayoub C, Ziade G. Injection laryngoplasty through a transoral approach using the Guedel oral airway. Acta Otorhinolaryngol Ital 2017; 37:444-446. [PMID: 28530260 PMCID: PMC5720873 DOI: 10.14639/0392-100x-1193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 12/23/2016] [Indexed: 12/04/2022]
Abstract
Injection laryngoplasty has gained popularity as a treatment modality for glottal insufficiency. Several approaches have been described, specifically transcutaneous, transoral and transnasal. The authors describe a novel technique performed successfully on three subjects, namely endoscopic injection laryngoplasty using the modified Guedel oral airway. There was marked improvement in dysphonia, maximum phonation time and closed quotient in all three subjects with a decrease in the Voice Handicap Index-10 score. This new approach is a viable approach for the treatment of glottal insufficiency.
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Affiliation(s)
- A L Hamdan
- Department of Otolaryngology, Head & Neck Surgery, American University of Beirut Medical Center, Beirut- Lebanon
| | - M Rizk
- Department of Anesthesiology, American University of Beirut Medical Center, Beirut-Lebanon
| | - C Ayoub
- Department of Anesthesiology, American University of Beirut Medical Center, Beirut-Lebanon
| | - G Ziade
- Department of Otolaryngology, Head & Neck Surgery, American University of Beirut Medical Center, Beirut- Lebanon
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Hamdan AL, Ziade G, Kasti M, Akl L, Bawab I, Kanj N. Phonatory Symptoms and Acoustic Findings in Patients with Asthma: A Cross-Sectional Controlled Study. Indian J Otolaryngol Head Neck Surg 2016; 69:42-46. [PMID: 28239577 DOI: 10.1007/s12070-016-1035-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 12/05/2016] [Indexed: 11/25/2022] Open
Abstract
To investigate the prevalence of phonatory symptoms, perceptual, acoustic and aerodynamic findings in patients with asthma compared to a control group. This study is a cross-sectional study. A total of 50 subjects, 31 asthmatic and 19 control subjects matched according to age and gender were enrolled in this study. All subjects were asked about the presence or absence of dysphonia, vocal fatigue, phonatory effort, cough, dyspnea, and respiratory failure. Perceptual evaluation, acoustic analysis and aerodynamic measurements were also performed. Patient's self assessment using the Voice Handicap Index 10 was reported. The mean age of patients was 43.5 years with a female to male ratio of 2:1. There was a statistically significant difference in the prevalence of dysphonia between the two groups (32.3 vs. 5.3%, p value 0.025) with a non-significant higher prevalence of vocal fatigue and phonatory effort. The overall grade of dysphonia was significantly higher in asthmatics compared to controls (p value 0.002). Patients with asthma had also significantly higher degree of asthenia and straining (p value of 0.04 and 0.008, respectively) with borderline significant difference with respect to roughness. There was no significant difference in the means of any of the acoustic parameters between patients and controls except for Shimmer, which was higher in the asthmatic group (p value of 0.037). There was also no significant difference in the Maximum phonation time between the two groups. Dysphonia is significantly more prevalent in patients with asthma compared to controls.
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Affiliation(s)
- Abdul Latif Hamdan
- Department of Otolaryngology, Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Georges Ziade
- Department of Otolaryngology, Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maher Kasti
- Department of Otolaryngology, Head and Neck Surgery, Rafic Hariri University Hospital, Beirut, Lebanon
| | - Leslie Akl
- Department of Otolaryngology, Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ibrahim Bawab
- Department of Otolaryngology, Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nadim Kanj
- Department of Internal Medicine, American University of Beirut, P.O. Box: 11-0236, Beirut, Lebanon
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Ziade GK, Karami RA, Fakhri GB, Alam ES, Hamdan AL, Mourad MM, Hadi UM. Reliability assessment of the endoscopic examination in patients with allergic rhinitis. Allergy Rhinol (Providence) 2016; 7:135-138. [PMID: 28107144 PMCID: PMC5244268 DOI: 10.2500/ar.2016.7.0176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objective: To study if nasal endoscope can be a reliable tool in assessing patients with allergic rhinitis. Materials and Methods: A prospective study. Patients who were diagnosed with allergic rhinitis underwent a nasal endoscopic examination performed by two physicians blinded to the scoring of each other. A correlation was made among symptom severity, endoscopic findings, and interrater variability. Results: Ninety patients were included in the study: 34 patients had mild disease and 56 had moderate-to-severe allergic rhinitis according to the Allergic Rhinitis and its Impact on Asthma guidelines. Increases in mucosal edema and bluish discoloration were predictive of the severity of allergic rhinitis disease (p < 0.05). The presence of nasal secretions was not predictive of allergic rhinitis. Interrater reliability was fair for mucosal edema, moderate-to-almost perfect for the rest of the endoscopic findings. Conclusion: Nasal endoscopy may reveal signs that are predictive of the severity of allergic rhinitis. A detailed checklist is needed for the nasal endoscopic examination to decrease interrater variability.
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Hamdan AL, Ziade G, Al-Zaghal Z, Tabri D, Sinno S, Saade R, Jabbour J, Nassar J. FORMANT CHARACTERISTICS OF ENGLISH-SPEAKING LEBANESE MEN. J Med Liban 2015; 63:209-212. [PMID: 26821404 DOI: 10.12816/0017969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To report the formant characteristics of English-speaking Lebanese men during steady prolongation of vowels /a/ and /i/. DESIGN Cross-sectional study involving volunteer participants. PARTICIPANTS Fifty healthy English-speaking males with a mean age of 32 ± 4.027 years and a range of 42 years (18-60). MATERIALS AND METHODS A total of 50 healthy males between the age of 18 and 60 were recruited for the study. Each subject was asked to phonate a sustained /a/ and /i/ sound at a comfortable pitch and intensity level. Measures were made in real-time and formant frequencies across F1, F2, F3 and F4 were determined using the Real-time Spectrogram VP 3950 (Kay Elemetrics, New Jersey). MAIN OUTCOME MEASURES The formant frequencies across F1, F2, F3 and F4 were recorded. RESULTS For the vowel /a/, the mean values of F1, F2, F3 and F4 were 622.86 ± 61.293 Hz, 1264 ± 78.602 Hz, 2610.90 ± 206.359 Hz and 3483.56 ± 206.833 Hz, respectively. For the vowel /i/, the corresponding values were 378.88 ± 51.825 Hz, 2210.34 ± 124.077 Hz, 2847 ± 168.770 Hz and 3576.82 ± 242.760 Hz, respectively. CONCLUSION Formant characteristics vary among cultures and ethnic groups.
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Hamdan AL, Ziade G, Jabbour J, Khneizer G, Kutkut I. NASALANCE SCORES IN LEBANESE ENGLISH-SPEAKING ADULTS USING NASOMETRIC ANALYSIS. J Med Liban 2015; 63:203-208. [PMID: 26821403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To obtain normative data for nasalance scores in Middle Eastern English-speaking adult population. DESIGN Cross-sectional study. PARTICIPANTS A total of 102 subjects were recruited in the study, 26 were excluded, thus, 77 Middle Eastern English-speaking adults (mean age = 23.77 ± 4.295; 39 males, 38 females) with normal speech and no hearing problems participated in the study. INTERVENTIONS Using Nasometer II 6450, nasalance scores were obtained for each participant's readings of 3 passages: Zoo and Rainbow passages and nasal sentences. MAIN OUTCOME MEASURES Mean nasalance score, standard deviation and range. RESULTS Mean nasalance scores for Zoo passage, Rainbow passage and nasal sentences were 25.21 ± 11.07, 34.04 ± 9.30 and 41.29 ± 9.87 respectively. Mean scores didn't differ significantly between males and females, though scores for the Zoo passage were slightly higher among males (26.51 ± 11.66) than females (23.87 ± 10.42). In within-session reliability testing, 86% of retests for all three passages fell within 5 nasalance points of the previous test. In across-session reliability testing, 93% of retests for all 3 passages were within 5 points of initial test. CONCLUSIONS AND RELEVANCE This study provides normative data for nasalance scores among Middle-Eastern adults, which can help make nasometer and determination of nasalance more clinically useful in this population.
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Turfe Z, Kanj N, Sarieddine D, Hamdan AL. Laryngopharyngeal Symptoms in Patients with Chronic Obstructive Pulmonary Disease. Otolaryngol Head Neck Surg 2014. [DOI: 10.1177/0194599814541629a165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: Report the prevalence and severity of laryngo-pharyngeal symptoms in patients with chronic obstructive pulmonary disease (COPD) compared with controls. Methods: A total of 27 patients with COPD and 13 controls matched according to age and sex were included. Demographic data included age, sex, history of smoking, and history of allergic rhinitis. The Reflux Symptom Index described by Belafsky et al was used. The frequency and average score of each of the laryngopharyngeal symptoms in both the patient group and controls were computed. Results: The mean age of patients was 61.67 years ± 11.09 years. Sixty-three percent were males and 37% were females. Ninety-two percent were smokers and 11.1% had allergic rhinitis. The mean of total Reflux Symptom Index in patients was significantly higher compared with controls (12.70 ± 7.06 vs 3.00 ± 2.94, P value <.05). In the COPD group, 18 subjects had a positive Reflux Symptom Index (>11) compared with 1 in the control group ( P value <.05). There was also a significant difference between the means of 6 laryngopharyngeal symptoms in patients versus controls. COPD patients had higher degree of hoarseness, throat clearing, excessive throat mucus, cough, and sticking sensation in the throat. Conclusions: Laryngopharyngeal reflux is more prevalent in COPD patients versus controls. The frequency and severity of laryngopharyngeal symptoms is significantly higher in COPD patients.
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Turfe Z, Kasti MM, Beydoun N, Hamdan AL. Phonatory Symptoms and Acoustic Findings in Patients with Asthma: A Cross-Sectional Controlled Study. Otolaryngol Head Neck Surg 2014. [DOI: 10.1177/0194599814541629a172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: Investigate the prevalence of phonatory symptoms, perceptual, acoustic, and aerodynamic findings in patients with asthma compared to a control group. Methods: A total of 50 subjects, 31 asthmatic and 19 control subjects matched according to age and sex, were enrolled in this study. All subjects were asked about the presence or absence of cough, dyspnea, respiratory failure, dysphonia, degree of vocal fatigue, and phonatory effort. Perceptual evaluation, acoustic analysis, and aerodynamic measurements were also performed. Patient self-assessment using the Voice Handicap Index 10 was reported. Results: The mean age of patients was 43.5 years with a female to male ratio of 2:1. There was a statistically significant difference in the prevalence of dysphonia between the 2 groups (32.3% vs 5.3%, P = .025) with a significant difference in the mean score of respiratory effort and vocal fatigue ( P = .019, .041, respectively). The overall grade of dysphonia was significantly higher in asthmatics compared to controls ( P = .002). Patients with asthma also had significantly higher degree of asthenia and straining with borderline significant difference with respect to roughness. There was no significant difference in the means of any of the acoustic parameters between patients and controls except for jitter. There was also no significant difference in the maximum phonation time between the 2 groups. Conclusions: Phonatory symptoms are significantly more prevalent in patients with asthma compared to controls.
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Turfe Z, Kanj N, Jaffal H, Attallah J, Hamdan AL. Prevalence of Phonatory Symptoms and Acoustic Findings in Patients with Chronic Obstructive Lung Disease. Otolaryngol Head Neck Surg 2014. [DOI: 10.1177/0194599814541629a174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: Investigate phonatory symptoms and acoustic and aerodynamic findings in patients with chronic obstructive lung disease (COPD) compared to a control group. Methods: A total of 40 subjects, 27 COPD and 13 control subjects matched according to age and sex, were enrolled in this study. All subjects were asked about the presence or absence of dysphonia, degree of vocal fatigue, and phonatory effort. Perceptual evaluation, acoustic analysis, and aerodynamic measurements were also performed. Patient self-assessment using the Voice Handicap Index 10 was reported. Results: There was a statistically significant difference in the prevalence of dysphonia between the 2 groups (12% vs 0%, P < .05) with a significant difference in the mean score of respiratory effort and vocal fatigue ( P = .011, .012, respectively). There was no significant difference in any of the perceptual parameters between the 2 groups except for roughness ( P = .009). There was no significant difference in the means of any of the acoustic parameters between patients and controls. There was also no significant difference in the maximum phonation time between the 2 groups ( P = .916). Conclusions: Dysphonia is significantly more prevalent in patients with COPD compared to controls.
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Hamdan AL, Jaffal H, Btaiche R, Turfe ZA, Bawab I, Kanj N, Tamim H. Laryngopharyngeal symptoms in patients with asthma: a cross-sectional controlled study. Clin Respir J 2014; 10:40-7. [PMID: 24995539 DOI: 10.1111/crj.12179] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 05/12/2014] [Accepted: 06/22/2014] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To examine the frequency and severity of laryngopharyngeal symptoms in asthmatic patients. The role of laryngopharyngeal reflux disease as a co-morbid disease to asthma has not been previously reported. SUBJECTS AND METHOD Seventy-two subjects, 36 asthmatics and 36 controls were included in this study. Demographic data included age, gender, status of asthma, use of steroid inhalers, smoking and history of allergy. Pulmonary function test was reported in 13 subjects. The evaluation consisted of filling the Reflux Symptom Index (RSI) described by Belafsky et al. The total score, frequency and average score of each laryngopharyngeal symptom was computed in both groups. RESULTS The mean age of patients was 46.61 ± 17.59 years with a female to male ratio of 2.3:1. Twenty patients were using steroid inhalers. Close to one third were smokers (30.6%) and 55.6% had allergic rhinitis. Thirty-six percent had controlled asthma vs 64% were uncontrolled. The mean of the total RSI was significantly higher in patients compared with controls (12.03 ± 8.3 vs 6.64 ± 6.08, P value < 0.05). In the asthmatic group, 15 subjects had a positive RSI compared with only 4 in the control group (P value of 0.003). There was a significant difference in the prevalence and means of four laryngopharyngeal symptoms in patients vs controls. CONCLUSION Laryngopharyngeal reflux disease is more prevalent and more severe in patients with asthma vs controls.
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Affiliation(s)
- Abdul Latif Hamdan
- Department of Otolaryngology - Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hussein Jaffal
- Department of Otolaryngology - Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rachel Btaiche
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Zaahir A Turfe
- Faculty of Medicine, Michigan State University College of Human Medicine, Beirut, Lebanon
| | - Ibrahim Bawab
- Department of Otolaryngology - Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nadim Kanj
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Hamdan AL, Homsi MT, Turfe Z, Boulos F. Pathology quiz: oncocytic cyst of the ventricular fold. Middle East J Anaesthesiol 2013; 22:213-215. [PMID: 24180174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- A L Hamdan
- Hamdan Voice Unit, Department of Otolaryngology-Head & Neck Surgery, American University of Beirut Medical Center, P.O. Box: 110236 Beirut, Lebanon.
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Hamdan AL, Al-Barazi R, Kanaan A, Al-Tamimi W, Sinno S, Husari A. The effect of snoring on voice: a controlled study of 30 subjects. Ear Nose Throat J 2012; 91:28-33. [PMID: 22278867 DOI: 10.1177/014556131209100110] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We conducted a study to determine the prevalence of vocal symptoms in snorers. A total of 30 patients with a history of snoring were investigated for the presence or absence of three vocal symptoms immediately after they awoke from sleep: hoarseness, voice weakness, and other changes in voice quality. All patients were also asked to complete a voice-related quality-of-life (V-RQOL) questionnaire. Findings were compared with those of an age- and sex-matched control group of 30 nonsnorers. The most common vocal symptom in the snoring group was hoarseness, which occurred in 11 patients (36.7%); voice weakness and other voice quality changes were present in 8 snorers each (26.7%). In the control group, the most common vocal symptom was voice weakness, which was present in 7 subjects (23.3%); 5 controls (16.7%) experienced other changes in voice quality, and 3 controls (10.0%) experienced hoarseness. The difference between the prevalence of hoarseness in the two groups was statistically significant (p = 0.030), and the differences in voice weakness and other voice quality changes were not. The mean V-RQOL score was 87.50 ± 26.89 in the snoring group and 96.00 ± 5.82 in the control group-again, not a statistically significant difference. Finally, we found no association between any of the three vocal symptoms and the prevalence of mouth breathing, the level of snoring loudness, and the mean number of snores per minute. We conclude that snorers are more likely to experience hoarseness than are nonsnorers.
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Affiliation(s)
- Abdul Latif Hamdan
- Department of Otolaryngology-Head & Neck Surgery, American University of Beirut, PO Box 11-0236, Beirut, Lebanon.
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Hamdan AL, Moukarbel RV, Tawil A, El-Khatib M, Hadi U. Tracheal schwannoma: a misleading entity. Middle East J Anaesthesiol 2010; 20:611-613. [PMID: 20394267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Primary tracheal tumors are rare with the majority being malignant. Benign lesions are less frequent with primary tracheal schwannomas accounting for less than 0.5% of tracheal tumors. They are more common in females and their clinical presentation is non-specific. Chronic cough, progressive respiratory distress and even asthma-like conditions prevail as presenting symptoms and signs. Laryngotracheal endoscopy reveals a solitary, well encapsulated mass arising most often from the posterior tracheal wall. The diagnosis of tracheal schwannomas is primarily pathological. Endoscopic excision, sleeve excision or tracheal resection, are all commonly accepted treatment modalities. Proper awareness of these lesions is crucial in the pre-operative work-up of patients presenting with stridor.
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Affiliation(s)
- Abdul Latif Hamdan
- Department of Otolaryngology-Head & neck Surgery, American University of Beirut Medical Center, Lebanon.
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Rameh C, Hourany-Rizk R, Hamdan AL, Natout M, Fuleihan N. Status of the remaining parotid duct and gland following superficial parotidectomy. Eur Arch Otorhinolaryngol 2007; 265:209-15. [PMID: 17849137 DOI: 10.1007/s00405-007-0429-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2007] [Accepted: 08/12/2007] [Indexed: 10/22/2022]
Abstract
The changes in Stensen's duct and remaining parotid tissue following superficial parotidectomy have not been studied previously. The aim of this clinical case control study is to describe these changes using sialography and CT-sialography techniques. Fourteen superficial parotidectomy cases underwent parotid sialography bilaterally. CT sialography was also done. Stensen's duct was patent in 11 cases (79%), and non-patent in three cases (21%). Its angle in relation to our reference line was 20 degrees in operated cases versus 37 degrees for the non-operated cases. Following superficial parotidectomy, the remaining parotid tissues usually remain functional and retain drainage through Stensen's duct. Furthermore, superficial parotidectomy changes the direction of this duct. Parotid sialography and CT sialography can still be used to study the status of remaining parotid tissue following superficial parotidectomy. The post-surgical changes should be reviewed with care before interpreting these studies.
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Affiliation(s)
- Charbel Rameh
- Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, PO Box: 11-0236, Beirut, Lebanon
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Affiliation(s)
- Abdul Latif Hamdan
- Department of Otolaryngology-HNS, American University of Beirut Medical Center, New York, NY 10022, USA.
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Hamdan AL, Ahmad H, Younes A, Hadi U, Fuleihan N. The etiologic role of the osteo-meatal complex in the pathogenesis of sinusitis: a retrospective study of clinical, CT and endoscopic findings in 143 patients. J Med Liban 2001; 49:329-32. [PMID: 12744635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
UNLABELLED The etiological role of the osteo-meatal complex (OMC) in the pathogenesis of sinus disease is a debatable issue. The charts of 143 patients who underwent endoscopic sinus surgery at the American University of Beirut Medical Center between 1992 and 1995 were reviewed. Clinical symptoms included facial pain, nasal obstruction, headache, and postnasal drip. CT scan and endoscopic findings were reviewed. The presence of OMC disease radiologically was correlated with all the clinical, nasal endoscopic and other radiologic findings (disease in the rest of paranasal sinuses, or presence of concha bullosa). Its etiological role in patients with sinusitis is discussed. RESULTS No endoscopic findings could be statistically correlated with the OMC disease. Facial pain and postnasal drip were the only clinical symptoms that statistically correlated with the OMC disease (p-value = 0.009 and 0.008, respectively). The OMC disease correlated with the radiological evidence of sinusitis in any of the sinuses.
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Affiliation(s)
- A L Hamdan
- Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center.
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Hamdan AL, Sharara AI, Younes A, Fuleihan N. Effect of aggressive therapy on laryngeal symptoms and voice characteristics in patients with gastroesophageal reflux. Acta Otolaryngol 2001; 121:868-72. [PMID: 11718254 DOI: 10.1080/00016480152602357] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Gastroesophageal reflux (GER) is associated with a variety of laryngopharyngeal signs and symptoms. Injury of the laryngopharynx as a result of GER can be refractory to conventional antireflux therapy. This prospective study was undertaken to evaluate the prevalence of laryngopharyngeal signs and symptoms in patients with documented GER and to assess the response to a high-dose combination antireflux therapy consisting of cisapride and pantoprazole. Twenty-two patients with symptoms of GER were enrolled. After baseline evaluation using a history questionnaire for symptoms, laryngeal endoscopy and vocal acoustic analysis, patients were started on treatment consisting of pantoprazole 40 mg b.d. and cisapride 20 mg twice daily. Repeat history and otolaryngologic evaluation was performed at 4 weeks. Laryngopharyngeal symptoms were frequent in most patients, with throat clearing and globus being the most prevalent symptoms followed by vocal fatigue and excess mucus production. Almost 90% of the patients had abnormal endoscopic laryngeal findings but the acoustic parameters did not show any abnormal results except for mild elevation in the shimmer. After treatment, all symptoms and endoscopic abnormalities improved significantly except for intermittent dysphonia and laryngeal mucosal redness. Acoustic abnormalities did not change significantly following therapy. Laryngeal symptoms and voice abnormalities are highly prevalent in patients with GER. Combination antireflux therapy with a proton pump inhibitor and a prokinetic agent results in rapid symptomatic and endoscopic response in the majority of patients.
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Affiliation(s)
- A L Hamdan
- Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Lebanon
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Hamdan AL, Zaytoun G, Shreif J, Tarazi A, Haddad M. Cerebrospinal fluid rhinorrhea: an unusual presentation of domestic violence. J Okla State Med Assoc 2001; 94:396-9. [PMID: 11577628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
The incidence of "battered woman syndrome" is increasing over the past few years affecting as many as one in every four families. Most of these cases present to the emergency room with mostly head and maxillofacial injuries. We are describing three cases of battered women with cerebrospinal fluid rhinorrhea as the only presenting symptom of domestic violence. The different etiologies, work up and treatment strategies are all discussed and reviewed.
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Abstract
BACKGROUND Congenital cysts of the neck in children are not uncommon. Most of these are thyroglossal, branchial cleft, or less commonly, thymic cysts. Bronchial cysts rarely are initially seen as a neck mass. METHODS Use of an illustrative case of a bronchogenic cyst initially seen as an upper lateral neck mass. CONCLUSIONS We emphasize that although ectopic bronchogenic cysts are rare lesions of the head and neck, especially in the upper lateral neck, they should be included in the differential diagnosis in the evaluation of congenital neck cysts.
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Affiliation(s)
- U M Hadi
- Department of Otolaryngology, Head & Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
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Hamdan AL, Hadi U, Farhat F, Jammal H, Fuleihan N. Challenges in tracheal stenosis--experience at the American University of Beirut Medical Center. Middle East J Anaesthesiol 2001; 16:211-22. [PMID: 11565434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- A L Hamdan
- Department of Otolaryngology, Head and Neck Surgery, American University of Beirut, Beirut, Lebanon
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Hamdan AL, Bizri AR, Jaber M, Hammoud D, Baino T, Fuleihan N. Nasoseptal variation in relation to sinusitis. A computerized tomographic evaluation. J Med Liban 2001; 49:2-5. [PMID: 11910961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Paraseptal structural abnormalities are common in patients with sinusitis. They may coexist with radiographic changes suggestive of sinusitis. Their etiological role in patients with no history of sinus disease is still controversial. In this study, computerized tomographic scan of orbits of 89 cases with no history of sinusitis were reviewed between 1996 and 1998. The incidence of septal deviation, concha bullosa and paradoxical middle turbinates was looked at. Their correlation with sinusitis was analyzed using CM-square statistical method. Results showed that the presence of these anatomical abnormalities is not associated with an increased incidence of sinusitis as shown radiologically. We conclude that the presence of septal deviation or large middle turbine on routine rhinoscopy does not mandate further radiological evaluation of the sinuses in the absence of history of sinusitis.
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Affiliation(s)
- A L Hamdan
- Dpt. of Otolaryngology-Head & Neck Surgery, American University of Beirut Medical Center, P.O. Box 11-0236, Beirut, Lebanon
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Hamdan AL, Mroueh SM, Bitar FF, Farhat FT. Foreign body retrieval in children with respiratory symptoms and no history of aspiration. Middle East J Anaesthesiol 2000; 15:673-80. [PMID: 11330222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
To asses the role of bronchoscopy and its yield in children with respiratory symptoms and no typical history of radiological evidence of foreign body aspiration (FBA), we reviewed the records of all patients who underwent bronchoscopy at our institution between 1985 and 1995 and had no history of choking, witnessed FBA or clear radiological evidence of FBA (N = 54, age range 4 months to 16 years). These were subdivided into two subgroups, those with positive bronchoscopy, and those with negative bronchoscopy. Respiratory symptoms and their duration, signs and radiological findings did not differ in both subgroups.
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Affiliation(s)
- A L Hamdan
- Department of Otorhinolaryngology and Head & Neck Surgery, American University of Beirut, 850 Third Avenue, New York, NY 10022, USA
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Affiliation(s)
- A L Hamdan
- Department of Otolaryngology-Head and Neck Surgery, American University of Beirut, Lebanon
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Kahwaji G, Hamdan AL, Mufarij A, Fuleihan NS. Plexiform Neurofibroma of the Sublingual Gland. Otolaryngol Head Neck Surg 2000; 122:927. [PMID: 10828814 DOI: 10.1016/s0194-59980070029-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- G Kahwaji
- Department of Otolaryngology-Head and Neck Surgery and Pathology, American University of Beirut-Medical Center, Lebanon
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Zealear DL, Billante CR, Chongkolwatana C, Rho YS, Hamdan AL, Herzon GD. The effects of chronic electrical stimulation on laryngeal muscle physiology and histochemistry. ORL J Otorhinolaryngol Relat Spec 2000; 62:81-6. [PMID: 10729797 DOI: 10.1159/000027722] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The present study examined the effects of functional neuromuscular stimulation (FNS) on posterior cricoarytenoid (PCA) muscle physiology and histochemistry. In 4 canines, 10 cm of the recurrent laryngeal nerve was resected. A patch electrode array was implanted for PCA stimulation. FNS was applied to 2 canines for a period of 4 weeks with 2 additional animals serving as nonstimulated controls. Results indicated that FNS increased PCA muscle contractility over the period of intervention but had no effect on contraction speed. FNS also protected the muscle from atrophy by preventing muscle weight loss and type 2 fiber deterioration. Finally, it rescued muscle fibers from ensuing fibrosis.
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Affiliation(s)
- D L Zealear
- Department of Otolaryngology, Vanderbilt University, Nashville, TN 37232, USA.
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Abstract
The effects of chronic posterior cricoarytenoid muscle denervation were assessed at 3 and 7 months in 26 animals following resection of 10 cm of recurrent laryngeal nerve with stump ligation. The physiology of denervation was characterized by a decrease in contraction strength and an increase in contraction time. The reduction in contraction strength reflected the loss in muscle weight and atrophic changes in fiber density and diameter. A change in muscle composition occurred because of the increased susceptibility of fast-twitch (type 2) fibers to degeneration. However, the compositional change alone could not account for the slowing of muscle contraction. Muscle fibrosis was negligible at 3 months, but encompassed one third of the fiber population by 7 months. In view of the irreversible nature of fibrosis, this study suggested that clinical intervention to rescue denervated posterior cricoarytenoid muscle fibers should be delayed no longer than 7 months to improve the chances for full recovery.
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Affiliation(s)
- D L Zealear
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Vanderbilt University, Nashville, Tennessee 37232
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