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Objective To investigate the correlation between the indications,findings,interventions of fibrobronchoscopy(FB) in neonates and their correlative diseases with neonatal FB results and clinical data.Methods Retrospective case series of 243 consecutive patients of 28 days old or younger were investigated underwent FB for the first time from January 2010 to December 2014,at a tertiary care hospital.The common indications for FB and detection rate of respiratory tract diseases were collected.If the findings of FB had significant associations with premature birth and other diseases were analyzed.Associations between interventions and basic illnesses were also analyzed.Results Of the 243 patients undergoing 275 procedures of FB,201 cases were boys(73.1％).The age of FB was (13.34 ± 9.76) days and the weight was (3.08 ± 0.68) kg.Forty-five cases were premature infants (16.4％).A total of 254 procedures were found to have congenital diseases (92.4％),and 177 cases of them had congenital heart diseases (CHD) (64.4％).Common indications for FB were dyspnea(140 cases,50.9％),tachypnea(82 cases,29.8％),and stridor(71 cases,25.8％).A total of 188 upper airway lesions were found and the most common findings were laryngomalacia(56 cases,20.4％) and vocal cord paralysis(bilateral/unilateral,50 cases,18.2％).A total of 315 lower airway lesions were found and the most common findings were airway mucosal inflammation (98 cases,35.6％),trachea and main bronchial stenosis (73 cases,26.5 ％).A total of 21 cases (7.6％) underwent supraglottoplasty during or after FB,while 17 cases (6.2％) underwent tracheal dilation and 10 cases (3.6％) underwent tracheotomy.Compared with non-CHD neonates,neonates with CHD were statistically significantly less likely to have congenital lesions statistically,such as laryngomalacia(15.8％ vs.28.6％,P =0.012),bilateral vocal cord lesions(6.2％ vs.21.4％,P =0.000) and congenital laryngeal dysplasia(0 vs.7.1％,P =0.001).The tracheotomy(0 vs.10.2％,P =0.000) and supraglottoplasty(2.3％ vs.17.3％,P =0.000) were more rare.Nevertheless,they were more likely to have secondary lesions such as the left main bronchial stenosis caused by extrinsic compression (23.7％ vs.1.0％,P =0.000),abnormal bronchial anatomy(9.6％ vs.2.0％,P =0.018),left vocal cord paralysis(9.0％ vs.1.0％,P =0.008) and airway mucosal inflammation(41.8％ vs.24.5％,P =0.004).The tracheostenosis and main broncial stenosis (37.3％ vs.7.1％,P =0.000) with long-term intubation(78.5％ vs.58.2％,P =0.000) were more common.There was no significant difference between term neonates and premature infants in the detection rate of respiratory tract diseases (P ＞ 0.05),tracheotomy (0 vs.4.3 ％,P =0.322),supraglottoplasty (13.3 ％ vs.6.5 ％,P =0.205) or long-term i ntubation (80.0％ vs.69.6％,P =0.157).Complications caused by procedure were rare and mild.Conclusions FB can detect whether the neonates with dyspnea,tachypnea and stridor have laryngomalacia,vocal cord paralysis,airway mucous edema,tracheal and main bronchial stenosis and other signs,and FB may play an important role in diagnosis,treatment and prognosis evaluation of neonatal respiratory diseases.
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OBJECTIVE@#To understand the vowel duration and statement reading of the adductor spasmodic dysphonia (ADSD) patients compared with their normal controls, and provide ideas for clinical diagnosis and treatment.@*METHOD@#Twenty-nine ADSD patients were included in the research, with 31 normal controls. All subjects filled in form voice handicap index (VHI) by themselves. Maximum phonetic time (MPT) and maximum loudness phonetic time(MLPT) were tested on /a/ sound for all patients. Also, all the patients were required to read aloud a standard mandarin assay named , duration were measured with Praat5. 0 software after sounds were collected. A one-way t-test was performed to compare spasmodic group with control group on VHI, MPT, MLPT and duration for reading standard sentences. Pearson/Spearman correlation was tested. Result: The VHI of the 29 ADSD patients is 89±12, and their normal controls 15±16, indicating that the VHI in ADSD group is significantly higher than in the control group(P<0. 01). The MPT of the ADSD group is(16. 9±9. 8 s), and the control group is (25. 3±10.0)s, indicating that MPT in the ADSD group is significantly shorter than the control group(P<0. 01). The MLPT of the ADSD group is (15.7±7. 6)s, and the control group is (26. 5±11. 4)s, indicating that MLPT in the ADSD group is significantly shorter than the control group (P<0. 01). The duration of standard sentence reading of the ADSD group is (55.0±14. 2)s, and the control group is (37. 8±4. 8)s, indicating that the duration of standard sentence reading in the ADSD group is significantly longer than the control group (P<0. 01). Correlation analysis showed that MPT and MLPT are related within the ADSD group(r=0. 697,P< 0.01), other indexes being tested have no significant correlations.@*CONCLUSION@#The voice disorder condition of the ADSD patients is significantly worse than normal people. Their pronunciations on continuous vowels are not lasting compared with normal people. In the meantime, their ability to read sentences is worse than normal people, needing longer time to complete the reading task. There is a significant correlation between MLPT and MPT, which can be used as an alternative to MPT.
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Humans , Case-Control Studies , Dysphonia , Diagnosis , Phonetics , Voice QualityABSTRACT
OBJECTIVE@#To investigate the characteristics of adductor spasmodic dysphonia phonatory break in mandarin Chinese and select the stimuli phrases.@*METHOD@#Thirty-eight patients with adductor spasmodic dysphonia were involved in this study. Standard phrase " fù mŭ xīn" and a speech corpus in mandarin Chinese with 229 syllables covering all vowel and constant of mandarin Chinese were selected. Every patient read the phrases above twice in normal speed and comfortable voice. Two auditory perpetual speech pathologists marked phonatory break syllables respectively. The frequency of phonatory break syllables and their located phrases were calculated, rated and described. The phrases including the most phonatory break syllables were selected as stimuli phrases, the phonatory break frequency of which was also higher than that of standard phrase "fù mŭ xīn".@*RESULT@#Phonatory break happened in the reading of all patients. The average number of phonatory break syllables was 14 (3-33). Phonatroy break occurred when saying 177 (77.3%) syllables in the speech corpus. The syllables "guŏ, rén, zāng, diàn, chē, gè, guăn, a, bā, ne, de" broke in 23.1%-41.0% patients. These syllables belonged to the phrases "pĭng guŏ, huŏ chē, shì de, nĭ shì gè hăo rén, wŏ mén shì yŏu zŏng shì bă qĭn shì nong dé hĕn zāng, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a,wŏ yīng gāi zài xìn lĭ xiĕ yī xiē shén mē ne?". Thirty-seven patients (97.3%) had phonatory break in above mentioned words. Ratios of these words phonatory break also were more than "fù mŭ xīn".@*CONCLUSION@#Adductor spasmodic dysphonic patients exhibited different degrees of phonatory break in mandarine Chinese. The phrases" shì de, pĭng guŏ, huŏ chē, nĭ shì gè hăo rén, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a" were recommended as stimuli phrases for adductor spasmodic dysphonia evaluation.
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Female , Humans , Male , Dysphonia , Diagnosis , Language , Phonation , Spasm , Diagnosis , VoiceABSTRACT
Objective To investigate the effect of voice training therapy on the voice improvement in patients with vocal nodules .Methods Twenty one patients with vocal nodules were recruited and were evaluated by the GRBAS perpetual evaluation ,voice handicap index (VHI)-30 subjective assessment ,vocal laryngostroboscopy , maximum phonation time (MPT) and acoustic analysis pre- and post-therapy .These patients completed 5 cour‐ses of voice training .Results The VHI value(29 .48 ± 21 .21) of post-therapy was less than the value (52 .95 ± 24 . 30)of pre -therapy (P< 0 .01) .There were significantly differences in voice perpetual evaluation between pre -training and post-training ,especially for G (grade) (P<0 .01) and R (roughness) (P<0 .01) .The post-training laryngostrobescopy vocal vibration improved comparing with pre-therapy in the closure of vocal cords ,symmetry of vibration ,the mucosal wave and vibration regularity of the vocal cords .After therapy ,three patient nodules dis‐appeared ,thirteen patient nodules became smaller ,and five patient nodules remained the same .The maximum pho‐nation time (MPT) (12 .54 ± 3 .68)of post-therapy was longer than MPT(8 .87 ± 3 .75) of pre-therapy MPT(P<0 .01) .The jitter value (0 .18% ± 0 .08% ) of post -therapy was less than that of pre-therapy(0 .43% ± 0 .31% ) (P<0 .01) .The shimmer of post -therapy (2 .10% ± 0 .98% ) was less than that of pre -therapy (4 .55% ± 1 .80% )(P<0 .01) ,The ratio of noise to harmonic(NHR)(0 .0034 ± 0 .0022 dB) of post-therapy was significantly less than NHR(0 .0184 ± 0 .028 dB)(P<0 .05) of pre-therapy .Conclusion The voice therapy could significantlyimprove voice of patients with vocal nodules .
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<p><b>OBJECTIVE</b>To investigate the applicability of the eysphonia severity index (DSI) in evaluating effects of surgery between before and after groups of vocal polyp patients.</p><p><b>METHODS</b>Analyses of measurement data pre and pro-surgery of 70 vocal polyp patients and 35 no voice disorders volunteers (control group). The voice quality was measured subjectively with the voice handicap index (VHI), the GRBAS and fiber electronic laryngoscopy. Measures of maximum phonation time (MPT), shimmer and jitter were obtained for each subject by using DiVAS 2.30 (XION, Germany). The DiVAS 2.30 had spotanenously calculate the scores of DSI. Using SPSS 17.0 to find the differences of DSI scores among the three groups by one-way ANOVA variance analysis. And finding out of the correlation with DSI scores and VHI scores, GRBAS, MPT, jitter and shimmer.</p><p><b>RESULTS</b>DSI improved significantly after surgery in the vocal polyps group (mean difference DSI -2.92 and 1.87, respectively) and also in the control group (mean difference DSI -2.92 and 2.30, respectively). However, no significant difference between the control group and the after surgery group. By using Pearson correlation analysis, this study observed a strong correlation between the DSI scores and the VHI scores, the values of GRBAS, shimmer (P < 0.01).</p><p><b>CONCLUSIONS</b>DSI is an effective and high accuracy multi-parameter system for evaluation of vocal cord polyp patients as an independent assessment of dysphonia. DSI also can be used in evaluation of the effects of the vocal polyps surgery.</p>
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Humans , Analysis of Variance , Case-Control Studies , Dysphonia , Diagnosis , Hoarseness , Laryngoscopy , Polyps , General Surgery , Severity of Illness Index , Vocal Cords , General Surgery , Voice QualityABSTRACT
OBJECTIVE@#To study surgical techniques and clinical applications of the intranasal endoscopic combined approach in maxillary sinus benign lesions surgery.@*METHOD@#A retrospective clinical analysis of 27 patients "whose unilateral maxillary sinus benign lesions operated by the intranasal endoscopic middle meatus with inferior meatus tears recess approach surgical treatment was studied.@*RESULT@#Benign lesions were confirmed by pathology in all patients before and after surgery as to rule out malignancy. All patients had been followed up for 12 to 24 months. Twenty-seven cases resulted in normal luminal epithelium and inferior turbinate shape after surgery. Only one case of papilloma relapsed 2 months after operation. So far, the papilloma has not recurred after the second surgery. There were no epiphora in all cases.@*CONCLUSION@#Endonasal endoscopic expand anterior tears recess approach have great and clear view. This approach made us accurately, mini-invade and completely remove the maxillary sinus benign lesions. It is a physiological and functional surgery and has great advantage in the nasal cavity disease treatment.
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Adult , Aged , Female , Humans , Male , Middle Aged , Endoscopy , Methods , Lacrimal Apparatus , General Surgery , Maxillary Sinus , Nasal Surgical Procedures , Methods , Nose , General Surgery , Paranasal Sinus Diseases , General Surgery , Retrospective StudiesABSTRACT
OBJECTIVE@#To investigate the clinical treatment effect of refractory hypertension accompanied with OSAHS by surgery on upper airway.@*METHOD@#Thirty-two patients were enrolled in our research. PSG and blood pressure were examined on preoperation and 6th month, 1 year, 2 year of postoperation.@*RESULT@#The AHI and the time of SaO2 < 90% were lower significantly, and LSaO2 was improved (P < 0.01). The blood pressures of 32 patients were decreased.@*CONCLUSION@#The operation on upper airway could improve the hypertension of patient with OSAHS effectively.
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Adult , Female , Humans , Male , Blood Pressure , Hypertension , General Surgery , Respiratory System , General Surgery , Sleep Apnea, Obstructive , General SurgeryABSTRACT
The voice is a complex multidimensional phenomenon. It is a drive through the lung airflow to vibrate the vocal cords, and then be perceived by the listeners. A multidimensional set of minimal basic measurements suitable for the voice diseases are proposed by the Committee on Phoniatrics of the European Laryngological Society in 2000. It includes five different aspects: the subjective physician perception (grade, roughness, breathiness), and subjective rating by the patient, videostroboscopy (closure, regularity, mucosal wave and symmetry), acoustics analysis and aerodynamics measurements. The first three are the subjective assessment of voice, these are not to be discussed in tis article. Only objective assessments of the voice and the latest research progress are summarized below.
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Humans , Acoustics , Vocal Cords , Voice QualityABSTRACT
OBJECTIVE@#To investigate whether the inflammation response and K(ATP) channel damage happened because of acute injury after functional electrical stimuli (FES) act on the recurrent laryngeal nerve (RLN).@*METHOD@#Thirty rabbits were divided into 3 groups by 10 rabbits for each group. The unilateral RNL were stimulated by FES with cuff electrode in first group. There was electrode on the RNL without FES in second group. The third group was normal control. The electrical generator and isolation unit provide electrical stimulation to the RLN at 50 Hz, with 4 mA current, for 2ms pulse duration. The total train duration was 5 seconds (2 seconds on; 3 seconds off). The RLN were collected in 1 hour after 3 hours electrical stimuli. We measured mRNA expression of injury acute response inflammation cytokine IL-10, TGF-beta1, TNF-alpha and K(ATP) Subunit protein Kir6.1, Kir6.2, SUR2AB, using real-time reverse transcribed-polymerase chain reaction. PCR products were verified by electrophoresis in agarose gels. We investigated the vocal synchronic adductive movement with RLN FES by endoscopy. We investigated the nerve local RNL morphological burn. Data were analyzed with the One-way ANOVA analysis of SPSS version 13.0 for Windows.@*RESULT@#There were no significance difference among three groups in mRNA expression of inflammation cytokines IL-10, TGF-beta1, TNF-alpha and K(ATP) channel protein Kir6.1, Kir6., SUR2AB. We did not find the nerve morphological burn in all rabbits RLN. The vocal synchronic adductive movement were normal during stimuli time.@*CONCLUSION@#The short duration functional electrical stimuli do not cause mRNA expression change of K(ATP) channel and acute inflammation cytokine in recurrent laryngeal nerve.
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Animals , Rabbits , Cytokines , Metabolism , Electric Stimulation , Inflammation , Interleukin-10 , Metabolism , KATP Channels , Metabolism , RNA, Messenger , Genetics , Recurrent Laryngeal Nerve , Metabolism , Physiology , Transforming Growth Factor beta1 , Metabolism , Tumor Necrosis Factor-alpha , MetabolismABSTRACT
OBJECTIVE@#To study the mRNA expression of muscle phenotype and collagen of soft palate and pathology in obstructive sleep apnea hypopnea syndrome (OSAHS).@*METHOD@#We used the Real-time PCR to test the mRNA expression of soft palate muscle myosin heavy chain (MyHC) phenotype and collagen in 12 OSAHS patients and 8 control patients. We also distinguished the muscle isoforms I , II with ATPase staining, then counted the numbers of isoforms muscle fiber.@*RESULT@#The mRNA expression of OSAHS group was more than control group in II A MyHC phenotype (P<0.01). The number of OSAHS group muscle fibre I isoform was less than control group with pH4. 3 ATPase staining (P<0.05).@*CONCLUSION@#Compare to control group, the enhancement happened in the mRNA expression of II A MyHC phenotype which can increase the velocity and power but de crease the enduring quality of muscle in OSAHS, and the reduce be in the I MyHC isoform of muscle fiber that can cause muscle velocity become slower and persistency become longer in OSAHS patients.
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Female , Humans , Male , Middle Aged , Case-Control Studies , Muscle Fibers, Skeletal , Metabolism , Pathology , Myosin Heavy Chains , Metabolism , Palate, Soft , Metabolism , Pathology , Phenotype , Protein Isoforms , Metabolism , RNA, Messenger , Genetics , Sleep Apnea, Obstructive , Metabolism , PathologyABSTRACT
OBJECTIVE@#To use the maximum loudest phonation time (MLPT) on evaluation of unilateral vocal fold paralysis.@*METHOD@#The MLPT, maximum comfortable phonation time (MCPT) and maximum phonation time (MPT) were tested and collected in 17 patients with unilateral vocal fold paralysis. The data of ratio value of MLPT to MCPT also was collected. The stroboscopy, perceptual measures and self-questionnaire also were used in evaluation of vocal fold and voice in all patients. Correlation coefficients were used as measures of agreement.@*RESULT@#MLPT was (5.0 +/- 4.0)s, MCPT was (5.4 +/- 4.1)s, and MPT was (6.1 +/- 4.5)s in patients. The MPT was composed of MLPT in 4 patients and MCPT in 13 patients. The MLPT/MCPTa was 1.08 +/- 0.47. MLPT was positively correlated with MCPT and MPT, respectively (r = 0.679, P < 0.01; r = 0.878, P < 0.01), and MCPT also was positively correlated with MPT (r = 0.993, P < 0.01). MLPT, MCPT and MPT was negatively correlated with G value which was from GRBAS scale, respectively (r = -0.620, P < 0.05; r = -0.564, P < 0.05; r = -0.665, P < 0.05). The MLPT/MCPTa was positively correlated with the value of question 4 from self-questionnaire (r = 0.534, P < 0.05). MLPT, MCPT or MPT had no correlation with self-questionnaire, GRBAS perceptual evaluation or stroboscopy measures significantly.@*CONCLUSION@#MLPT, MCPT or MPT can be used for evaluation of aerodynamic measures in unilateral vocal fold paralysis. The MLPT may be easiest to operate in clinic. The MLPT/MCPTa ratio can assess dysphagia in unilateral vocal fold paralysis patients.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Phonation , Vocal Cord Paralysis , Pathology , Vocal Cords , Pathology , Voice QualityABSTRACT
A case of a fibrous histiocytoma (FH) of the larynx in a 54-year-old male is reported. Laryngeal fibrous histiocytoma is uncommon. The case recurred several times over 4-year period. Its pathology is described including arguments on potential malignancy and the way of management.
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Objective To investigate the expression of the mRNA of muscle fibre types in the denervated post cricoarytenoid(PCA)muscle of rat.Methods Unilateral recurrent laryngeal nerve of eight rats were removed.Eight rats were used as controls.The mRNA expression of heavy chain myosin of PCA muscle fibre subtypes was measured with real-time quantitative RT-PCR in control rats and denervated rats 40 days after denervation.Results Compared to the control group,there were no significantly differences in mRNA expression of each muscle subtype between two groups.The ratio of MyHC type I to IIB was increased significantly(P=0.018).Conclusion The increased ratio of MyHC subtype I to IIB suggests the decreased contraction power of denervated PCA muscle.
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Objective To determine the normal value and clinical significance of the lengths and angles of both mandible and hyoid, and their relationship with cervical vertebra as well as the transverse area of the airway at the hyoid level using CT. Methods Several lines and angles on the CT images were measured in 68 normal subjects. Line A was the length between both free ends of the mandible; line B was the distance from the body of the mandible to line A; Line C was the distance from line A to the anterior aspect of the cervical vertebra. ?1 was the angle between the middle of mandible body and its two free ends. Line a was the distance between two free ends of greater horn of hyoid bone. Line b was the distance from hyoid to line a. line c was the distance from line a to the cervical vertebra ?2 was the angle between the middle of hyoid body and its two free ends. S stood for the area of the airway at the hyoid level. SPSS 11.5 statistical analysis package was used to analyze the results. Results The average and median distance/angle of various measurements were as follows: bne A was (89. 28?5. 90) mm and 88. 70 mm, line B was (62. 61?5. 78) mm and 62. 50 mm, line C was (9. 29?3. 29) mm and 4. 20 mm, ?1 was (71. 25? 6. 77)? and 71. 05? , line a was (38. 69?6. 07) mm and 39. 90 mm, line b was (28. 79?4. 37) mm and 28.50mm, line c was (1.91?3.03) mm and 1.75 mm, ?2 was (68.47?15.71)? and 66.95?.The average S was (436. 14?160. 37) mm and median was 431. 75mm2. Conclusion It's easy to measure the three lines and the two angles of mandible and hyoid. The measurement is of vital importance in the diagnosis and treatment for obstructive sleep apnea syndrome.
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Objective To determine the relation between level of caloric responses and temperature of stimulus.Methods An bithermal caloric air irrigator was used to obtain maximum slow component speed caloric responses of 120 patients reported history of dizziness. The nystagmus was measured and recorded by electronystagmography.Results The maximum slow-phase speed of the responses to hot air was greater than that to cold air ( P