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Zhu X, Zhao R, Feng C, Cheng Y, Zhang X, Deng Q, Liu H. [Application of acellular dermal matrix in prevention of laryngeal stenosis in glottic carcinoma]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2024; 38:321-324. [PMID: 38563176 DOI: 10.13201/j.issn.2096-7993.2024.04.011] [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] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Indexed: 04/04/2024]
Abstract
Objective:To investigate the effect of acellular dermal matrix in preventing laryngeal stenosis in glottic carcinoma patients. Methods:Fifty-five patients with glottic carcinoma(T2, T3) from February 2018 to December 2022 were divided into experimental group(28 cases) and control group(27 cases) according to their wishes. Acellular dermal matrix was placed in the operation cavity in the experimental group after laryngofission, while control group 12 cases were sutured by pulling the upper and lower edges, 15 cases were repaired with sternohyoid muscle fascia flap. Results:In the experimental group, 1 case had laryngeal stenosis caused by laryngeal mucosa swelling after operation, and extubated successfully after symptomatic treatment. In the control group, 7 cases had laryngeal stenosis after operation, of which 3 cases were caused by granulation tissue hyperplasia in laryngeal cavity, and extubated after symptomatic treatment. 2 cases extubated after operation suffered from progressive dyspnea during radiotherapy, and underwent tracheotomy again, extubation successful after treatment. 2 cases caused by laryngeal mucosa swelling, after symptomatic treatment, one case was successfully extubated, and one case had long-term intubation. The laryngeal stenosis rate of the experimental group was 3.6%(1/28) , which was lower than control group 25.9%(7/27), and the therapeutic effect of the experimental group was significantly better than control group (χ²=5.526, P=0.019). Conclusion:Implanting acellular dermal matrix in the operation cavity of glottic carcinoma can reduce the occurrence of laryngeal stenosis and have satisfactory preventive effect on laryngeal stenosis.
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Affiliation(s)
- Xin Zhu
- Department of Otolaryngology,Affiliated Hospital of North Sichuan Medical College,Nanchong,637000,China
| | - Rui Zhao
- Department of Otolaryngology,Affiliated Hospital of North Sichuan Medical College,Nanchong,637000,China
| | - Chengmin Feng
- Department of Otolaryngology,Affiliated Hospital of North Sichuan Medical College,Nanchong,637000,China
| | - Yao Cheng
- Department of Otolaryngology,Affiliated Hospital of North Sichuan Medical College,Nanchong,637000,China
| | - Xi Zhang
- Department of Otolaryngology,Affiliated Hospital of North Sichuan Medical College,Nanchong,637000,China
| | - Qicheng Deng
- Department of Otolaryngology,Affiliated Hospital of North Sichuan Medical College,Nanchong,637000,China
| | - Hai Liu
- Department of Otolaryngology,Affiliated Hospital of North Sichuan Medical College,Nanchong,637000,China
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Lin F, Zhao J, Lu YX, Zou JZ, Xiao P, Liang JQ, Pang C, Gu QL. [Analysis of clinical characteristics of children with adenoid hypertrophy and pharyngolaryngeal reflux]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2024; 59:140-146. [PMID: 38369792 DOI: 10.3760/cma.j.cn115330-20231221-00318] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Objectives: To explore the clinical characteristics of children with adenoid hypertrophy (AH) and laryngopharyngeal reflux (LPR) by detecting the expression of pepsin in adenoids as a standard for AH with LPR. Methods: A total of 190 children who were admitted for surgical treatment due to AH were included in the study. The main clinical symptoms of the patients were recorded, and the degree of adenoid hypertrophy was evaluated. Before the surgery, Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) were used to evaluate the reflux symptoms. After the surgery, pepsin immunohistochemical staining was performed on the adenoid tissue, and according to the staining results, the patients were divided into study group (pepsin staining positive) and control group (pepsin staining negative). SPSS 19.0 software was used for statistical analysis. Quantitative data conforming to normal distribution between the two groups were tested by two-independent sample t test, and quantitative data with skewed distribution were tested by Mann-Whitney U test. Results: The positive rate of pepsin staining in the 190 AH patients was 78.4% (149/190). The study group had higher levels of preoperative symptoms such as erythema and/or congestion of the pharynx(2.1±0.7 vs. 1.8±0.6,t=2.23), vocal cord edema[1.0(0, 1.0) vs. 1.0(0, 1.0), Z=2.00], diffuse laryngeal edema[0(0, 1.0) vs. 0(0, 0), Z=2.48], posterior commissure hypertrophy[(1.4±0.6 vs. 1.1±0.5), t=2.63], and a higher total score on the RFS scale than the control group(6.2±2.7 vs. 5.0±2.6, t=2.47), with statistical differences (P<0.05). The sensitivity and specificity of RFS score in diagnosing AH with LPR were 24.8% and 80.5%, respectively. When RFS>5 was used as the positive threshold, the sensitivity and specificity of RFS score in diagnosing AH with LPR were 61.1% and 58.5%, respectively. There was a statistical difference in the number of positive cases of RFS score between the study group and the control group(91 vs. 17,χ2=5.04,P=0.032). Conclusions: LPR is common in AH children. Children with AH and LPR have specific performance in electronic laryngoscopy, such as erythema with edema in the pharynx, posterior commissure hypertrophy, and vocal cord edema.
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Affiliation(s)
- F Lin
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital, Capital Institute of Pediatrics,Beijing 100020,China
| | - J Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital, Capital Institute of Pediatrics,Beijing 100020,China
| | - Y X Lu
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital, Capital Institute of Pediatrics,Beijing 100020,China
| | - J Z Zou
- Department of Pathology, Children's Hospital Capital Institute of Pediatrics,Beijing 100020,China
| | - P Xiao
- Department of Pathology, Children's Hospital Capital Institute of Pediatrics,Beijing 100020,China
| | - J Q Liang
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital, Capital Institute of Pediatrics,Beijing 100020,China
| | - C Pang
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital, Capital Institute of Pediatrics,Beijing 100020,China
| | - Q L Gu
- Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital, Capital Institute of Pediatrics,Beijing 100020,China
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Tessler I, Primov-Fever A, Soffer S, Anteby R, Gecel NA, Livneh N, Alon EE, Zimlichman E, Klang E. Deep learning in voice analysis for diagnosing vocal cord pathologies: a systematic review. Eur Arch Otorhinolaryngol 2024; 281:863-871. [PMID: 38091100 DOI: 10.1007/s00405-023-08362-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 11/17/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVES With smartphones and wearable devices becoming ubiquitous, they offer an opportunity for large-scale voice sampling. This systematic review explores the application of deep learning models for the automated analysis of voice samples to detect vocal cord pathologies. METHODS We conducted a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. We searched MEDLINE and Embase databases for original publications on deep learning applications for diagnosing vocal cord pathologies between 2002 and 2022. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). RESULTS Out of the 14 studies that met the inclusion criteria, data from a total of 3037 patients were analyzed. All studies were retrospective. Deep learning applications targeted Reinke's edema, nodules, polyps, cysts, unilateral cord paralysis, and vocal fold cancer detection. Most pathologies had detection accuracy above 90%. Thirteen studies (93%) exhibited a high risk of bias and concerns about applicability. CONCLUSIONS Technology holds promise for enhancing the screening and diagnosis of vocal cord pathologies. While current research is limited, the presented studies offer proof of concept for developing larger-scale solutions.
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Affiliation(s)
- Idit Tessler
- Department of Otolaryngology Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- ARC Innovation Center, Sheba Medical Center, Tel-Hashomer, Israel.
| | - Adi Primov-Fever
- Department of Otolaryngology Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shelly Soffer
- Internal Medicine B, Assuta Medical Center, Ashdod, Israel
- Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Roi Anteby
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Surgery and Transplantation B, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Nir A Gecel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nir Livneh
- Department of Otolaryngology Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eran E Alon
- Department of Otolaryngology Head and Neck Surgery, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Zimlichman
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- ARC Innovation Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Eyal Klang
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- ARC Innovation Center, Sheba Medical Center, Tel-Hashomer, Israel
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Fujiki RB, Sanders PW, Anthony BP, Parker NP, Sivasankar MP, Halum S. Can Resident Auditory-Perceptual Voice Assessments Predict Medical Urgency of Voice Disorders? J Voice 2024; 38:181-188. [PMID: 34479778 DOI: 10.1016/j.jvoice.2021.07.009] [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: 03/01/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND/OBJECTIVES Growing reliance on telemedicine has created new triaging challenges. This study investigated how effectively otolaryngology resident auditory-perceptual voice assessments performed via telemedicine determined the need for urgent in-person clinic visits. METHODS Twelve otolaryngology resident physicians (PGY1-PGY5) performed auditory-perceptual assessments on 25 voice samples recorded during initial voice evaluations. Voice samples were balanced in severity and taken in equal numbers from patients with the following diagnoses: benign laryngeal lesions, laryngeal cancer, functional voice disorders, laryngeal edema (associated with LPR), and laryngeal paralysis/paresis. Urgent diagnoses were defined as laryngeal cancer and severe unilateral laryngeal paralysis. For each voice sample, residents were initially blinded to patient medical history. Residents rated severity of voice disorder, predicted patient diagnosis, and determined the urgency of seeing the patient in clinic. Residents then reviewed information from the patient's medical history and again rated urgency of voice disorder. RESULTS On average, residents identified urgent voice disorders in 56% of cases. After reviewing medical history, this number significantly increased to 77% (P = 0.001). Voice severity, smoking history, time since onset, and course of symptoms were considered most influential when determining medical urgency of voice patients. Year in residency program had no effect on rating accuracy. As expected, diagnostic accuracy of auditory-perceptual assessments was low, ranging from 40% for laryngeal paralysis/paresis to 5% for laryngeal edema. CONCLUSION Auditory-perceptual voice assessment, combined with medical history, predicted most medically urgent voice disorders. Further work should investigate if task-specific training might improve these results and which medical history items are most critical. Until accuracy of auditory-perceptual assessment of medical urgency is improved, these data underscore the importance of laryngeal examination in identifying medical urgency and etiology of dysphonia.
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Affiliation(s)
| | | | - Benjamin P Anthony
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine
| | - Noah P Parker
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine
| | | | - Stacey Halum
- Department of Speech, Language, and Hearing Sciences, Purdue University; Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine.
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Cantarella G, Pignataro L. A High-Definition 3-Dimensional Exoscope With the ARTip Cruise System as an Effective New Tool for Phonosurgery: A Preliminary Report. J Voice 2024; 38:210-213. [PMID: 34373157 DOI: 10.1016/j.jvoice.2021.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 06/09/2021] [Revised: 06/29/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
The aim of phonosurgery is to improve voice quality and efficiency by performing precise, minimally invasive, conservative treatment. Magnified visualization of the vocal folds is mandatory to achieve optimal results; operative microscopy has been utilized so far to perform phonosurgery. In recent decades, the use of an exoscope (extracorporeal telescope) has been proposed in several fields of surgery that necessitate magnification. Further technological advancements have enabled 3-dimensional (3D) technology to be added to existing exoscopes. Recently, a motorized holding arm (the ARTip Cruise System) was developed to allow smooth precise positioning of the 3D Vitom exoscope (Karl Storz, Tuttlingen, Germany) by the surgeon without need for assistance. To evaluate the feasibility of phonosurgery by means of this innovative system, we utilized it for six consecutive procedures for benign laryngeal pathologies, including two vocal fold polyps, two cysts, one Reinke's edema and one unilateral vocal fold paralysis treated by fat augmentation. All procedures were performed without any technical difficulty and with excellent results at follow-up, as demonstrated by GRBAS, VHI-10 and maximal phonation time evaluations. Main advantages of this technique were the enhanced depth of field and high definition of anatomical details. Communication with the operating room team was facilitated by the shared view of the same images on screen; furthermore, the surgeon could perform the procedures visualizing the surgical site without need to position the eyes on the microscope eyepieces and so being able to wear full face protection, which was of paramount importance in the era of the COVID-19 pandemic. In conclusion, the 4K 3D exoscope system with the ARTip Cruise System represents a promising innovation in the field of voice surgery to allow highly precise procedures optimizing safety and co-operation with the operating room team.
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Affiliation(s)
- Giovanna Cantarella
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan; Otolaryngology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan; Otolaryngology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Shimada Y, Suyama Y, Koizumi M, Hagiwara K. Laryngeal edema in drug reaction with eosinophilia and systemic symptoms syndrome due to sulfasalazine. Int J Rheum Dis 2023; 26:2317-2319. [PMID: 37317785 DOI: 10.1111/1756-185x.14783] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/24/2023] [Accepted: 06/02/2023] [Indexed: 06/16/2023]
Abstract
We present a case of a 47-year-old man with drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. The patient had been diagnosed with rheumatoid arthritis and sulfasalazine was prescribed 4 weeks before admission. Initial symptoms with fever and rash worsened even after a discontinuation of the medication, and concomitant symptoms developed including typical manifestations of facial rash and edema sparing the periorbital area, as well as atypical laryngeal edema. Rheumatologists should be aware that sulfasalazine is derived from sulfonamide and can possibly induce DRESS syndrome, one of the life-threatening drug eruptions.
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Affiliation(s)
- Yusuke Shimada
- Department of General Medicine, Nerima Hikarigaoka Hospital, Tokyo, Japan
| | - Yasuhiro Suyama
- Department of Rheumatology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Megumi Koizumi
- Department of Otolaryngology, JR Tokyo General Hospital, Tokyo, Japan
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Thomas MG, Carstea A, Rashid M, Niblett D. Reinkes oedema causing severe airway obstruction with relatively mild symptoms. BMJ Case Rep 2022; 15:e249811. [PMID: 35537769 PMCID: PMC9092136 DOI: 10.1136/bcr-2022-249811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/03/2022] Open
Affiliation(s)
- Matthew George Thomas
- Bedfordshire Hospitals NHS Foundation Trust, Luton, UK
- Anaesthetic Department, Bedford Hospital, Bedford, UK
| | - Adrian Carstea
- Bedfordshire Hospitals NHS Foundation Trust, Luton, UK
- ENT, Bedford Hospital, Bedford, UK
| | - Mamun Rashid
- Bedfordshire Hospitals NHS Foundation Trust, Luton, UK
- ENT, Bedford Hospital, Bedford, UK
| | - David Niblett
- Bedfordshire Hospitals NHS Foundation Trust, Luton, UK
- Anaesthetic Department, Bedford Hospital, Bedford, UK
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Lopes LW, França FP, Evangelista DDS, Alves JDN, Vieira VJD, de Lima-Silva MFB, Pernambuco LDA. Does the Combination of Glottal and Supraglottic Acoustic Measures Improve Discrimination Between Women With and Without Voice Disorders? J Voice 2020; 36:583.e17-583.e29. [PMID: 32917459 DOI: 10.1016/j.jvoice.2020.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/20/2019] [Revised: 08/04/2020] [Accepted: 08/06/2020] [Indexed: 12/28/2022]
Abstract
AIM To analyze the accuracy of traditional acoustic measurements (F0, perturbation, and noise) and formant measurements in discriminating between women with and without voice disorders, and with different laryngeal disorders. STUDY DESIGN A descriptive, cross-sectional, and retrospective. METHOD Two hundred and sixty women participated. All participants recorded the spoken vowel /Ɛ/ and underwent laryngeal visual examination. Acoustic measures of the mean and standard deviation of the fundamental frequency (F0), jitter, shimmer, glottal-to-noise excitation ratio, and the values of the first three formants (F1, F2, and F3) were obtained. RESULTS Individual acoustic measurements did not demonstrate adequate (<70%) performance when discriminating between women with and without voice disorders. The combination of the standard deviation of the F0, shimmer, glottal-to-noise excitation ratio, F1, F2, and F3 showed acceptable (>70%) performance in classifying women with and without voice disorders. Individual measures of jitter as well as F1 and F3 demonstrated acceptable (>70%) performance when distinguishing women with different laryngeal diagnoses, including without voice disorders (healthy larynges), Reinke's edema, unilateral vocal fold paralysis, and sulcus vocalis. The combination of acoustic measurements showed excellent (>80%) performance when discriminating women without voice disorder from those with Reinke's edema (mean of F0, F1, and F3) and with sulcus vocalis (mean of F0, F1, and F2). CONCLUSIONS Individual formant and traditional acoustic measurements do not demonstrate adequate performance when discriminating between women with and without voice disorders. However, the combination of traditional and formant measurements improves the discrimination between the presence and absence of voice disorders and differentiates several laryngeal diagnoses.
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Affiliation(s)
- Leonardo Wanderley Lopes
- Professor at the Department of Speech-Language Pathology at the Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil.
| | - Fernanda Pereira França
- Ph.D Candidate of the Graduate Program in Linguistics at the Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
| | - Deyverson da Silva Evangelista
- Ph.D Candidate of the Graduate Program in Linguistics at the Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
| | - Jônatas do Nascimento Alves
- Master degree of the Graduate Program in Linguistics at the Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
| | - Vinícius Jefferson Dias Vieira
- Post doctorate researcher in the Graduate Program in Linguistics at the Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
| | - Maria Fabiana Bonfim de Lima-Silva
- Professor at the Department of Speech-Language Pathology at the Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
| | - Leandro de Araújo Pernambuco
- Professor at the Department of Speech-Language Pathology at the Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
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Eckel EH, Glanz H, Hess M, Nawka T, Schultz-Coulon HJ. [Phoniatry and ENT on: dagnostic and therapeutic problems with organic voice disorders]. Laryngorhinootologie 2003; 82:756-7. [PMID: 14634889 DOI: 10.1055/s-2003-44542] [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: 10/26/2022]
Affiliation(s)
- E H Eckel
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Städtische Kliniken Neuss, Germany
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King HK, Huntington C, Khan AK. Difficult intubation in a patient with thoracic trauma. Anaesthesia 1995; 50:371-2. [PMID: 7747868 DOI: 10.1111/j.1365-2044.1995.tb04629.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Abstract
During an 8-year period, 66 patients with recurrent respiratory papillomatosis underwent 890 laser microlaryngoscopy procedures. A retrospective analysis of immediate and delayed complications occurring with laser microlaryngoscopy in the treatment of these patients revealed that complications secondary to anesthetic technique and laser methodology were remarkably low (0.3%). Delayed complications of tissue injury (36% of pediatric patients and 17% of adult patients) were more frequent and included anterior glottic webbing, interarytenoid scarring and arytenoid fixation, vocal fold fibrosis, and generalized endolaryngeal glottic stenosis. All patients were evaluated by direct visualization and recording at the time of the operative procedure, as well as by review of intraoperative photographs. A smaller group of patients underwent analysis of voice recordings and laryngeal stroboscopy. The frequency and severity of tissue injury was higher in the patients with more severe disease who underwent multiple operative procedures.
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Affiliation(s)
- D M Crockett
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City
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Abstract
Hereditary Angio-Edema (HAE) is manifested by recurrent attacks of acute circumscribed edema of the extremities, face, trunk, and respiratory or abdominal tract, occurring after minor physical or emotional trauma, or spontaneously. The clinical diagnosis can be confirmed by low serum-levels of the inhibitor of the activated first component of complement (C1-INH). A family of 35 members over six generations was investigated. About 40 per cent of the members were HAE-patients. An autosomal dominant inheritance with high penetrance was present. Four patients died by suffocation from laryngeal edema. In all HAE-patients the C1-INH serum-level was diminished, and also in two children who have yet had no complaints. Adequate medical advice, including the provision of a medical alert card and the prescription of C1-INH concentrate (for short-term prophylaxis and the treatment of attacks of laryngeal edema), is necessary. In patients with frequent serious attacks, long-term prophylaxis with Danazol is indicated.
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14
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Abstract
Burn mortality statistics may be misleading unless they account properly for the many factors which may influence outcome. In reviewing such factors in our patients, we identified age, total burn area, third degree burn area, prior bronchopulmonary disease, abnormal Pao2, and airway edema as the factors present on admission which best distinguished survivors from nonsurvivors. Using multifactorial probit analysis, we then calculated the contribution of each to the probability of fatal outcome. The resultant six-factor model significantly improved estimation of the probability of fatal outcome when compared to probit analysis based only on the traditional factors of age and total burn area. It also revealed a spectrum of mortality probabilities varying with the additional factors present. Although crucial in comparing different approaches to burn care, consideration of such prognostic factors will not eliminate the need for randomized treatment trials, because other factors, some of which are obscure, may also influence mortality rates in burned patients.
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Yonkers AJ. Diagnosing and treating common disorders of the larynx. Geriatrics (Basel) 1973; 28:150-5. [PMID: 4700068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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17
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Sţefaniu A, Romaşcanu G, Ene F, Stefan A. [Recurrent Quincke's disease with laryngeal localization]. Otorinolaringologie 1973; 18:67-72. [PMID: 4571005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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18
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Behrman SJ. Complications of sagittal osteotomy of the mandibular ramus. J Oral Surg 1972; 30:554-61. [PMID: 4537684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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19
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Miroshnikova EZ. [Angioneurotic edema of the larynx]. Vestn Otorinolaringol 1970; 32:114-5. [PMID: 5510878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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22
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Piccoli A. [Prolonged endotracheal intubation in syndromes of acute respiratory insufficiency]. Clin Otorinolaringoiatr 1967; 19:212-22. [PMID: 5603399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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23
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Grüter L. [Recurring affection with stenosing laryngotracheobronchitis in related children]. HNO 1967; 15:91-2. [PMID: 5593523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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24
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Mitrović K, Cvetković S, Vuciciević B. [Quincke's oedema of the larynx]. SRP ARK CELOK LEK 1966; 94:57-62. [PMID: 5984646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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BUSH GH. ANAESTHETIC IMPLICATIONS OF STRIDOR IN CHILDREN. Proc R Soc Med 1965; 58:270-1. [PMID: 14263739 PMCID: PMC1898407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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HAZARD DC. ELECTIVE TRACHEOTOMY. J Oral Surg 1965; 23:101-7. [PMID: 14238968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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CARLIN RT. SOME PATHOPHYSIOLOGIC ASPECTS OF THE LARYNX RELATED TO INTUBATION ANESTHESIA. J Am Dent Soc Anesthesiol 1965; 12:80-4. [PMID: 14284658 PMCID: PMC2033240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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DOWIE LN. A Case of Alcohol Induced Pain of the Larynx with Aphonia. J Laryngol Otol 1964; 78:1051-2. [PMID: 14222848 DOI: 10.1017/s0022215100063167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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ISHII H, BABA T. [POLYPOID DEGENERATION OF THE VOCAL CORD]. Nihon Jibiinkoka Gakkai Kaiho 1964; 67:1638-44. [PMID: 14279171 DOI: 10.3950/jibiinkoka.67.11_1638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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SAMITZ A. [CURRENT VIEWS ON POSTINFLUENZAL LARYNGEAL PERICHONDRITIS]. HNO 1964; 12:318-20. [PMID: 14337182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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MROVEC J, HUBACEK J. [ LARYNGEAL EDEMA IN SO-CALLED MELKERSSON-ROSENTHAL SYNDROME]. Cesk Otolaryngol 1964; 13:363-7. [PMID: 14250706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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MINNIGERODE B. [ON THE EFFECT OF RESPIRATORY LOCOMOTION OF LARYNX AND TRACHEA ON THE PATHOGENESIS OF INTUBATION INJURIES WITH SPECIAL REFERENCE TO ARTIFICIAL ALTERNATING-PRESSURE RESPIRATION]. Z Laryngol Rhinol Otol 1964; 43:613-7. [PMID: 14342453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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GHARIB R. CLINICAL PATHOLOGICAL CONFERENCE. THE CHILDREN'S HOSPITAL MEDICAL CENTER, BOSTON, MASS. J Pediatr 1964; 65:625-30. [PMID: 14216653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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POULSEN AO, SIMONSEN J. [ACUTE EPIGLOTTITIS WITH FATAL OUTCOME. 11 CASES]. Ugeskr Laeger 1964; 126:1294-6. [PMID: 14229269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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MIYAJIMA Y. [NECK BURN AND LARYNGEAL EDEMA CAUSED BY EXPLODING FIREWORKS]. Jibiinkoka 1964; 36:753-5. [PMID: 14199595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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SCHLOSSHAUER B. [ON THE TERMINOLOGY AND TREATMENT OF CHRONIC LARYNGOPATHIES]. HNO 1964; 12:169-71. [PMID: 14225160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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KOHOUT E, SEHAT A, ASHRAF M. ANTHRAX: A CONTINOUS PROBLEM IN SOUTHWEST IRAN. Am J Med Sci 1964; 247:565-75. [PMID: 14158491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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MORSE HR. RECENT DEVELOPMENTS IN THE DIAGNOSIS & TREATMENT OF ACUTE LARYNGEAL OBSTRUCTION. Eye Ear Nose Throat Mon 1964; 43:44-8. [PMID: 14143778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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BLAHOVA O, MERTENOVA J, KROO AH, SIXTOVA E. [CARE OF PATIENTS WITH ACUTE STENOSING LARYNGOTRACHEOBRONCHITIS]. Cesk Pediatr 1964; 19:412-5. [PMID: 14155143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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DIETEL K, SCHMIDT H. [ON ACQUIRED ACUTE LARYNGEAL STENOSIS IN CHILDHOOD]. Z Arztl Fortbild (Jena) 1964; 58:377-81. [PMID: 14214950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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KULICKA F, MROVEC J. [COMPLICATIONS FOLLOWING ENDOTRACHEAL ANESTHESIA]. Cesk Otolaryngol 1964; 13:93-9. [PMID: 14152315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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KIRCHNER JA. SURGICALLY-INDUCED DISORDERS OF THE VOCAL CORDS. Conn Med 1964; 28:24-8. [PMID: 14106183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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ZITTI E, POPESCU L, CIRSTEA M, DINKE G. [ACUTE RESPIRATORY INSUFFICIENCY IN THORACIC SURGERY]. Vestn Khir Im I I Grek 1963; 91:11-8. [PMID: 14150479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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NEMETH B, FARKAS E, JASPER A, ECKHARDT S. [DIAGNOSTIC DIFFICULTIES IN THE CASE OF CANCER]. Magy Onkol 1963; 7:248-52. [PMID: 14112375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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JAUMANN K, SINZINGER G. [TANDERIL IN OTORHINOLARYNGOLOGY WITH SPECIAL REFERENCE TO THE POSTOPERATIVE EDEMA]. HNO 1963; 11:332-4. [PMID: 14113889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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