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Isshiki systematically developed thyroplasty in the 1970 s. Based on Isshiki′s classification of thyroplasty, laryngeal framework surgery was classified by the Phonosurgery Committee of the European Laryngological Society in 2001. Then laryngeal framework surgery became more systematic and standardized, and made new progress in clinical applications and basic theoretical research. This article mainly expounds new progress in laryngeal framework surgery over the last five years.
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Laryngeal diseases are closely related to the swallowing and speech function of the patients.Protecting and restoring laryngeal function, while curing lesions, is vital to patients′ quality of life.Photodynamic therapy (PDT) is a minimally invasive method which is widely used in the treatment of tumor, precancerous lesions, and inflammatory diseases.In recent years, it has been shown to have a protective effect on normal structures. This article reviews the clinical outcomes of laryngeal diseases treated with PDT since 1990 in order to evaluate its efficacy and significance. The complete remission rate of early-stage laryngeal tumors and precancerous lesions after PDT is 77.6%(249/321), and a promising effect on recurrent laryngeal papillomatosis has been observed thus far. The prolonged adverse effects of the first-generation photosensitizers have limited the application of PDT. With the improvement of photosensitizers and treatment strategies, PDT promises to be a safe, effective, and minimally invasive treatment method for laryngeal diseases.
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Objective:To investigate the optimal time of tracheotomy/arytenoidectomy and the improvement of dyspnoea, dysphonia and dysphagia after arytenoidectomy with CO₂ laser in iatrogenic bilateral vocal folds paralysis patients. Method:Thirty patients [29 females, 56 (49-60) years, one male, 49 years] with bilateral vocal cords paralysis resulted from neck surgery were retrospectively analyzed by case archived information and following-up questionnaire. The data included patients' dysponea time, degree and duration from tracheotomy/arytenoidectomy to neck surgery. Twenty sixty patients required unilateral partial/total arytenoidectomy. The results of treatment were evaluated by questionnaire including dyspnoea, dysphonia and dysphagia. Result:All patients whose bilateral vocal paralysis were resulted from thyroid gland surgery. Dysponea occurred immediately after thyroidectomy surgery in 14 cases (46.7%), and 2 years later after thyroidectomy in 13 cases (43.3%), 8 years later in 3 cases (10.0%). There was one (3.3%) patient without tracheotomy. The duration of tracheotomy/arytenoidectomy to neck surgery was significantly correlated with duration of tracheotomy/arytenoidectomy to dyspnoea appearance (r=0.879, P<0.05), not correlated with duration of thyroid surgery to dyspnoea appearance. There is significantly negative correlation between degree of dyspnoea and duration of tracheotomy/arytenoidectomy to neck surgery (r=0.452, P<0.05). Twenty six patients appeared dyspnoea and underwent CO₂ laser arytenoidectomy after thyoidectomy 0.5-23 years. Five patients did unilateral total arytenoidectomy and 21 patients did unilateral partial arytenoidectomy. After 12-96 months following up, dyspnoea improved in 24 patients, no improved in 2 patients. Dysphonia improved and remained in 17 patients, being worse mildly in 8 patients and obviously in one patient. Dysphagia improved and remained in 24 patients, being worse in 2 patients. There was no difference between total and partial arytenoidectomy in dyspnoea, dysphonia and dysphagia. Conclusion:The morbidity of dyspnoea was correlated with time after neck surgery. It was rarely necessary to take tracheotomy immediately in bilateral vocal fords paralysis patients after neck surgery. The severer degree of dyspnoea led to shorter duration between neck surgery and tracheotomy/arytenoidectomy. There was obvious improvement after arytenoidectomy in dyspnoea, no significant change in dysphonia and dysphagia. The effect of total arytenoidectomy on bilateral vocal paralysis was similar to partial arytenoidectomy.
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<p><b>OBJECTIVE</b>To investigate the application and significance of aerodynamic parameters in voice function assessment.</p><p><b>METHODS</b>The phonatory aerodynamic system (PAS) was used to collect aerodynamic parameters from subjects with normal voice, vocal fold polyp, vocal fold cyst, and vocal fold immobility. Multivariate statistical analysis was used to compare measurements across groups.</p><p><b>RESULTS</b>Phonation threshold flow (PTF), mean flow rate (MFR), maximum phonation time (MPT), and glottal resistance (GR) in one hundred normal subjects were significantly affected by sex (P < 0.05), while phonation threshold pressure (PTP), subglottal pressure (SGP), and vocal efficiency (VE) were not (P > 0.05). PTP, PTF, MFR, SGP, and MPT were significantly different between normal voice and voice disorders (P < 0.01), and there were no significant differences among the three disorders (P > 0.05). Receiver operating characteristic (ROC) analysis found that PTP, PTF, SGP, MFR, MPT, and VE in one hundred thirteen voice dis orders had similar diagnostic utility (P < 0.01), with PTP exhibiting the highest area under the curve. The aerodynamic parameters of the three degrees of voice dysfunction due to vocal cord polyps were compared and found to have no significant differences (P > 0.05). PTP, PTF, MFR, SGP and MPT in forty one patients with vocal polyps were significantly different after surgical resection of vocal cord polyps (P < 0.01).</p><p><b>CONCLUSION</b>The aerodynamic parameters can objectively and effectively evaluate the variations of vocal function, and have good auxiliary diagnostic value.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Glottis , Physiology , Laryngeal Diseases , Diagnosis , Multivariate Analysis , Phonation , Physiology , Polyps , Diagnosis , Vocal Cords , Physiology , Voice Disorders , Diagnosis , Voice QualityABSTRACT
Thiol rice straw [TRS] was prepared by esterifying thioglycolic acid onto rice straw in the medium of acetic anhydride and acetic acid with sulfuric acid as catalyst. The sorption of lead [Pb] on TRS from aqueous solution was subsequently investigated. The batch experiments showed that Pb removal was dependent on initial pH, sorbent dose, Pb concentration, contact time, and temperature. The maximum value of Pb removal appeared at pH 5. For 100 mg/L of Pb solution, a removal ratio of greater than 98% could be achieved with 2.0 g/L or more of TRS. The isothermal data of Pb sorption conformed well to the Langmuir model, and the maximum sorption capacity [Q[m]] of TRS for Pb was 104.17 mg/g. The equilibrium of Pb removal was reached within 120 min. The Pb removal process could be described by the pseudo-first-order kinetic model. The thermodynamic study indicated that the Pb removal process was spontaneous and endothermic