Isolated Hyoid Fracture Associated with Blunt Trauma

Trauma-related hyoid fractures are rare entities. These fractures represent only 0.002% of head and neck region fractures. Victims of hanging and strangling constitute the great majority of cases. Fractures associated with trauma are extremely rare. These fractures are difficult to diagnose and can easily be overlooked during physical examination. However, they are also important traumas since airway safety is endangered in these rare cases. We describe a case of a young male presenting with isolated neck injury associated with hitting an electric cable while riding a motorbike. Tenderness was present in the anterior neck region at physical examination, but movement was not restricted and no respiratory difficulty was determined. Isolated hyoid fracture was detected at tomography of the neck performed in the emergency department. Hyoid bone fractures should not be forgotten in patients with pain and tenderness in the anterior neck region following blunt trauma to the neck.©Copyright 2020 by Emergency Physicians Association of Turkey - Available online at www.jemcr.com.

Left Vocal Cord Palsy Immediately After COVID-19 Despite No Tracheal Intubation.

The cases of coronavirus disease 2019 (COVID-19) typically present with pulmonary and upper respiratory tract symptoms, but may also present with neurologic complications. Because severe cases are often intubated or ventilated, there are some reports of vocal cord palsy associated with intubation; however, there are few reports of recurrent nerve palsy without intubation management. We experienced a case of left vocal cord palsy following COVID-19 in a healthy young male patient with no previous medical history. The patient became aware of hoarseness symptoms three days after he was found to be COVID-19 positive, and an endoscopic examination of the larynx revealed left vocal cord palsy. Since the patient had no previous medical history and there were no lesions that could cause recurrent nerve palsy on neck-thorax imaging, it was considered likely that the patient had unilateral recurrent nerve palsy due to acute inflammation caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Medication was started and his hoarseness became relieved. In vocal cord palsy occurring after COVID-19 illness, it is necessary to consider the presence of both vocal cord palsy related to tracheal intubation and recurrent nerve palsy associated with SARS-CoV-2 infection.

An acoustic analysis and comparison between remotely collected and in-person laboratory collected data in vocal imitation of pitch

Restrictions on face-to-face interactions due to the outbreak of the coronavirus pandemic (COVID-19) in early 2020 have impacted experimental behavioral research. The rapid change from in-person to online data collections has been challenging in many behavioral studies, especially those that require vocal production, and the quality of the remotely collected data needs to be investigated. The current study examines the recording quality and corresponding measures of vocal production accuracy in online and in-person settings using two measurements: harmonic-to-noise ratio (HNR) and fundamental frequency, f 0. Participants imitated pitch patterns extracted from recordings of song or speech, either in a laboratory or via an online platform. The results showed that the recordings from the online setting had higher HNR than those from the in-person setting, whereas the pitch imitation accuracy in both settings did not differ. We also report an experiment that simulated differences between the online and in-person settings within participants, focusing on software used, type of microphone, and presence of ambient noise. Pitch accuracy did not differ according to these variables, except ambient noise, whereas HNR again varied across conditions. Based on these results we conclude that measures of pitch accuracy are reliable across these different types of data collection, whereas finer-grained spectral measures like HNR might be affected by various factors. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Practice of singing in virtual mode to develop primary emotions in university students

Currently, the development of primary emotions through a singing workshop for university students is a relevant issue, where, due to the Covid 19 pandemic, the teaching-learning process has been transformed into a virtual modality, therefore, generating certain emotional difficulties such as discouragement, anguish, depression, etc. Therefore, the objective of this research is to determine the percentage of emotional development of university students before and after the application of the singing workshop. The methodology responds to a pre-experimental, quantitative investigation with a descriptive scope. The findings focus on the identification of the emotions that the students bring before and after each workshop session, the active participation of the 8 sessions of singing practice in virtual mode in a creative way, the adaptation that the students made in their houses for the practice of singing and the importance of the musical repertoire that was used. It is concluded that the development, control and education of emotions is vital for the life of man as a decisive process to live in harmony with the society that surrounds him, therefore, his progress must be monitored. © 2022, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.

Preliminary Diagnosis of COVID-19 using Speech Processing Techniques

This project aims to devise an alternative for Coronavirus detection using various audio signals. The aim is to create a machine-learning model assisted by speech processing techniques that can be trained to distinguish symptomatic and asymptomatic Coronavirus cases. Here the features exclusive to the vocal cord of a person is used for covid detection. The procedure is to train the classifier using a data set containing data of people of various ages both infected and disease-free, including patients with comorbidities. We presented a machine learning-based Coronavirus classifier model that can separate Coronavirus positive or negative patients from cough, breathing, and speech recordings. The model was trained and evaluated using several machine learning classifiers such as Random Forest Classifier, Logistic Regression (LR), Decision Tree Classifier, k-nearest Neighbour (KNN), Naive Bayes Classifier, Linear Discriminant Analysis, and a neural network. This project helps track COVID-19 patients at a low cost using a non-contactable procedure and reduces the workload on testing centers. © 2023 IEEE.

Effect of COVID-19 on the incidence of postintubation laryngeal lesions.

Background: Critically ill patients intubated in the intensive care unit experience prolonged intubation leading to increased frequency of laryngeal injuries. This study aimed to demonstrate a suspected increase in vocal fold injury in patients who were intubated with COVID-19 as compared with patients intubated for other reasons. Methods: A retrospective review of medical records was performed to identify patients examined using flexible endoscopic evaluation of swallowing exams. The study included 25 patients with COVID-19 and 27 without COVID-19 at Baylor Scott & White Medical Center in Temple, Texas. Various injuries were evaluated, ranging from granulation tissue to vocal cord paralysis. Severe lesions were those causing clinically significant airway obstruction or requiring operative intervention. The incidence of laryngeal injury in patients intubated for COVID-19 was then compared with that of patients intubated for other reasons. Results: The increased presence of severe injury in COVID-positive patients appeared clinically significant but was not statistically significant (P = 0.06). Interestingly, patients who received pronation therapy had 4.6 times the odds of more severe injury compared with patients who did not (P = 0.009). Conclusion: Lower thresholds for performing flexible laryngoscopy on postintubated patients who are proned may allow for earlier intervention and reduce morbidity in an already at-risk population.

Dysfunctional breathing induces vocal cord dysfunction following COVID-19 infection

Introduction/Aim: SARS-CoV-2 (COVID-19) has affected over 60 million people world-wide. In most cases symptoms are mild, however some people have ongoing symptoms lasting longer known as 'long COVID'. Exertional breathlessness is a common complaint in these patients. Dysfunctional breathing (DB) and vocal cord dysfunction (VCD) are two underappreciated causes of breathlessness. We hypothesized that in individuals who had experienced COVID-19, dysfunctional breathing could give rise to VCD. Method(s): Nine convenience-sampled participants with confirmed COVID-19 infection were included following resolution of the acute illness. Vocal cords movements were visualised via continuous laryngoscopy. Hyperventilation was employed as a surrogate for DB, using a standard protocol of 40 breathes per minute (bpm). Participants breathed through a flow sensor with concomitant laryngoscopy, and we monitored hyperventilation, gas exchange measurements and laryngeal movements. After 12-weeks patients returned for repeat hyperventilation testing. Result(s): The nine participants consisted of five females and four males, age range 24-66 years. Three of the nine participants developed classic inspiratory VCD during hyperventilation. Patients with VCD were female, younger (<45), reported significantly reduced exercise tolerance post infection and had been physically very active prior to COVID infection. In two participants VCD associated with hyperventilation had resolved on laryngoscopy at 12-weeks. In these two participants who had VCD, breathlessness and reduced exercise tolerance resolved at 12-weeks following laryngeal retraining. In one person evidence of VCD and reduced exercise tolerance persisted post 12-weeks review. Conclusion(s): This study provides the first evidence that COVID-19 may facilitate VCD via DB, causing unexplained breathlessness. Our findings suggest that this disease process may be implicated in 'long COVID' and provide a rationale for therapies such as breathing and laryngeal retraining.

Relationship Between Vocal Fatigue Index and Acoustic Voice Scales in Patients With Coronavirus Infection.

OBJECTIVES: The voice quality of patients with Coronavirus Disease 2019 (COVID-19) seems to be affected due to lower and upper respiratory involvement. Patient-based voice assessment scales are important clinical measures to diagnose voice disorders and monitor treatment outcomes in COVID-19 patients. This study compared vocal fatigue between COVID-19 patients and those with normal voices. Furthermore, the relationship between vocal fatigue and acoustic voice parameters of COVID-19 patients was evaluated. METHODS: This cross-sectional study enrolled 30 laboratory-confirmed patients with COVID-19 (18 males and 12 females) and 30 healthy individuals with normal voices (14 males and 16 females) to compare their respiratory or phonatory parameters. The Persian versions of the Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) and the vocal fatigue index (VFI) were conducted before and after reading the text. The Jitter, shimmer, maximum phonation time, and harmonic-to-noise ratio (HNR) were analyzed by Praat software based on the recorded voices of CAPE-V tasks. The acoustic assessment and VFI questionnaire results were compared between COVID-19 patients and the control group. RESULTS: There were significant differences between COVID-19 patients and their healthy counterparts in all VFI subscales (P < 0.001). Moreover, after reading the text, we found significant differences between the two groups regarding Jitter, shimmer, and HNR of /a/ and /i/ vowels (P < 0.05). Our findings also indicated a significant correlation between symptom improvement with rest and acoustic parameters in all tasks, except the Jitter of /a/ before reading the text. CONCLUSION: Patients with COVID-19 showed significantly more vocal fatigue than people with normal voices after reading the text. Moreover, there was a significant relationship between Jitter, shimmer, and HNR and the tiredness of voice and physical discomfort subscales of VFI.

Vocal Disorders in Patients with COVID 19 in Egypt.

COVID-19 is considered a respiratory disease which has many symptoms associated with the larynx and the lungs infections. COVID-19 has wide spectrum of clinical features starting from mild symptoms to severe illness. Otolaryngological symptoms as nasal obstruction, loss of smell, taste dysfunction, sore throat, sticky mucus, and dysphagia are common in COVID-19 patients. Other vocal symptoms as dysphonia and phonesthenia are common in COVID-19 patients. The aim of this study is to detect the occurrence of vocal symptoms in COVID-19 patients in Egypt and to investigate the videolaryngoscopic findings associated with these symptoms. A total number of 106 patients diagnosed with COVID-19 were randomly assessed for vocal symptoms. The following epidemiological and clinical data were collected: age, gender, smoking consumption, general symptoms, otolaryngological and vocal symptoms as dysphonia and phonesthenia. Auditory perceptual assessment of voice and videolaryngoscopic examination were done. The occurrence of dysphonia and phonesthenia were observed in COVID -19 patients. Of the 106 patients, 84 patients (79%) were dysphonic, 20 (18.8%) patients were phonesthenic. The correlation of the different otolaryngological symptoms with dysphonia and phonesthenia were reported. A significant correlation was found between dysphonic patients and rhinorrhea, taste dysfunction, sore throat, and cough. A significant correlation was found between phonesthenic patients and allergic rhinitis. Videolaryngoscopic findings were detected in COVID-19 patients. Vocal fold congestion was found in 42 patients (39.6%), benign vocal fold swellings was found in 18 patients (16.9%), ventricular hypertrophy was found in 6 patients (0.05%), unilateral vocal fold immobility was found in 14 patients (13.2%), and vocal fold congestion associated with ventricular fold hypertrophy was found in 20 patients (18.8%).There was significant correlation of dysphonia and phonesthenia with vocal fold congestion (P value:0.001, P value:0.039 respectively).There was a significant correlation between cough and vocal fold congestion (P value: 0.000). Benign vocal fold swellings were associated with 18 patients (16.9%), but it was not statistically significant (P value: 0.931). Dysphonia and phonesthenia were observed in patients with mild to moderate COVID-19.The vocal symptoms were associated with different laryngoscopic findings, in which, vocal fold congestion was the commonest.

Optimal Tracheostomy Timing Through Modeling Based on Severity of Vocal Cord Injury.

BACKGROUND: Endotracheal intubation is a routinely performed procedure in the ICU. Whereas it is recognized that endotracheal intubation can result in laryngeal and tracheal injury, this study evaluated factors that may affect the incidence of posterior vocal cord ulcers (PVCUs). METHODS: One thousand three hundred fifty-five patients were retrospectively screened from 2002-2018 that received a tracheostomy with routine bronchoscopy at a single institution. Post tracheostomy operative notes were reviewed and included only if proper visualization of the vocal cords was documented. Primary outcome measures included presence of PVCU, length of time on a ventilator until a tracheostomy, hospital length of stay, and mortality. Stratification of the data focused on the severity of the ulcer (mild, moderate, and severe) and was analyzed using analysis of variance, multivariate analysis, and Kaplan-Meier modeling of PVCU incidence over time. RESULTS: We enrolled 192 subjects with documentation of vocal cord visualization. Thirty-nine subjects did not have a PVCU, whereas 153 subjects did. A median duration of 9 (interquartile range [IQR] 5-13) d was associated with developing a mild PVCU, whereas individuals intubated for a median of 6 (IQR 4-7) d were ulcer free. Statistical difference between length of time on a ventilator before tracheostomy and the severity of the PVCU seen was significant (P < .001). The Kaplan-Meier model showed that beyond 2 weeks of endotracheal intubation subjects will have > 80% chance of developing a moderate vocal cord ulcer. Whereas by day 7, there is only a 20% chance of developing a moderate ulcer. CONCLUSIONS: Earlier tracheostomy placement was associated with reduced severity of vocal cord ulcer formation. The Kaplan-Meier model suggests that waiting for 14 d is likely too long and earlier placement of a tracheostomy, within a week, may decrease the morbidity of posterior vocal cord injury.

The Role of Ultrasonography in Evaluating the Function of the Vocal Cords, Post-Thyroidectomy

Objective: Although there are several methods to assess vocal cord (VC) paralysis, direct flexible laryngoscopy (DFL) is used as a main diagnostic modality. In recent years, transcutaneous laryngeal ultrasonography (TLUS) has emerged as an alternative method to evaluate VCs. The objective of this study was to investigate the efficiency of TLUS in the evaluation of VCs, post-thyroidectomy. Materials and Methods: The study included 93 patients who had undergone thyroid surgery. All patients were examined using DFL, 1 to 3 days before surgery, to evaluate their VC functions. Patients were examined using DFL and TLUS on postoperative day 7. Patients' age, sex, diagnosis, type of surgery, preoperative DFL findings, postoperative DFL, and TLUS findings were recorded. Results: Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPVs) were 75% (6/8), 98.66% (74/75), 85.71% (6/7), and 97.36% (74/76), respectively. The diagnostic accuracy of TLUS was 97.96%. The area under the receiver operator characteristic (ROC) curve was 0.869, P value <.0001 (95% confidence inteval, 0.75–1.00), which indicated that TLUS was a good tool for identification of VC palsy in this cohort of post-thyroidectomy patients. Conclusion: This cohort study demonstrated that TLUS was a reliable diagnostic tool to evaluate VC functions in patients after thyroidectomy. It may be used as a safer alternative during the ongoing COVID-19 pandemic due to the lack of human-originated aerosols. © The Author(s) 2023.

Predicting Airflow from Measures Sensitive to Mid-cord Glottal Gap During the COVID-19 Pandemic.

OBJECTIVES: To determine if trans-laryngeal airflow, important in assessing vocal function in paresis/paralysis and presbylarynges patients with mid-cord glottal gaps, could be predicted by other measures sensitive to mid-cord glottal gap size but with smaller risks of spreading COVID-19, and if any patient factors need consideration. METHODS: Four populations were: unilateral vocal fold paresis/paralysis (UVFP, 148), aging and UVFP (UVFP plus aging, 22), bilateral vocal fold paresis/paralysis without airway obstruction (BVFP, 49), and presbylarynges (66). Five measures were selected from the initial clinic visit: mean airflow from repeated /pi/ syllables, longer of 2 /s/ and 2 /z/ productions, higher of 2 cepstral peak prominence smoothed for vowel /a/ (CPPSa), and Glottal Function Index (GFI). S/Z ratios were computed. Stepwise regression models used 3 measures and 5 patient factors (age, sex, etiology, diagnosis, and potentially impaired power source for voicing) to predict airflow. RESULTS: Log-transformations were required to normalize distributions of airflow and S/Z ratio. The final model revealed age, sex, impaired power source, log-transformed S/Z ratio, and GFI predicted log-transformed airflow (R2 = .275, F[5,278] = 21.1; P < .001). CONCLUSIONS: The amount of variance explained by the model was not high, suggesting adding other predictive variables to the model might increase the variance explained.

Speech handicap and vocal tract discomfort with different types of face masks in the COVID-19 era

Purpose: Compulsory use of masks is recommended to prevent droplet infection during the COVID-19 pandemic. This can alter optimal communication in daily life. This study compared the self-perceived speech handicap and vocal tract discomfort when wearing and not wearing a face mask and different types of face masks in a healthy population. Methods: This is a cross-sectional study conducted via an online questionnaire. Speech Handicap Index (SHI) and Vocal Tract Discomfort Scale (VTDS) scores were collected via Google forms (Google, Mountain View, California) from 128 healthy Korean populations with and without face masks and different types of face masks. Results: While speaking with a face mask, subjects were identified with a significant lack of air, unclear articulation, and reduced speech intelligibility in a noisy situation. Although total SHI and VTDS scores exhibited slightly higher with a face mask, no significant differences were found between with and without mask conditions. For mask type, individuals who frequently wore KF94 masks subjectively perceived significantly higher speech handicap and vocal tract discomfort than surgical or fabric masks. Conclusions: In the current study, wearing a face mask did not have a significant impact on speech handicap and vocal tract discomfort in a healthy adult population during the CO-VID-19 pandemic period, implying people already adapted to wearing a face mask. In terms of speech problems and frequency, the severity of sensation or symptoms of vocal discomfort significantly differed depending on which face mask type they used. Future research should address self-evaluation of their feeling or experience due to face mask use, considering the elderly and patients with communication disorders who suffer more with communication in daily life. © 2022 The Korean Association of Speech-Language Pathologists.

Platelet-Rich Plasma for Vocal Fold Scar: A Preliminary Report of Concept.

INTRODUCTION: Vocal fold atrophy and scar can lead to loss of normal superficial lamina propria, negatively affecting the vibratory function of the vocal fold. These changes can lead to dysphonia, vocal fatigue, decreased volume, and altered pitch. Treatment options for these conditions are limited. Platelet-rich plasma (PRP) consists of platelets, growth factors, and cytokines derived from the patient's own blood and is believed to activate tissue regeneration. The purpose of this study was to review the technical aspects of collecting PRP and injecting it into the vocal fold injection - based on our initial experience with this procedure. CASE: A patient with vocal fold scar was identified and enrolled in an ongoing prospective clinical trial study of a series of 4 monthly subepithelial vocal fold PRP injections, which was temporarily halted due to the COVID-19 pandemic. Patient underwent a single injection of autologous PRP into the left vocal fold. There were no adverse events during the study period. Subjective improvement in voice was noted at 1 month after injection with subsequent return to baseline over the next 4 months. Videostroboscopy performed on postinjection day 1 and day 7 and demonstrated no concerning exam changes. Compared to the preinjection baseline, the patient-reported voice-handicap index-10 (VHI-10) and voice catastrophization index were similar at 4 months following injection (20 to 20 and 4 to 3, respectively). Independent perceptual analysis of voice showed improvement at 4 months postinjection, compared to baseline consensus auditory-perceptual evaluation of voice 60 to 44. CONCLUSIONS: This preliminary report was part of a prospective trial investigating the use of PRP to treat vocal fold atrophy and scar. This work highlights the technical considerations for injecting PRP into the vocal fold. Planned prospective enrollment in this study will help to validate the safety and efficacy of PRP injections.

Transjugular Approach for Recurrent Intracranial Glomus Vagale Tumors: An Ideal Approach to Preserve Hearing and Facial Nerve Function

Lateral skull base paragangliomas (glomus tumors) are rare skull base tumors arising from neuroendocrine cells. These benign tumors can be locally aggressive with potential for intracranial extension and significant morbidity as they compromise cranial nerve structures. Treatment is highly patient dependent. Herein, we present a case of recurrent glomus vagale paraganglioma requiring a multidisciplinary transjugular and transcervical approach for complete resection. A 64-year-old male was referred to the neurotology clinic in 2019 for a left skull base tumor causing progressive dysphonia and dysphagia. Exam revealed left true vocal fold weakness and no other abnormalities. Hearing was normal on the left. Magnetic resonance imaging (MRI) revealed a large hyperintense lesion of the left jugular foramen with intracranial cerebellopontine angle extension and normal flow through the sigmoid sinus and jugular vein. The patient elected for surgical removal and near-total resection was achieved via retrosigmoid craniotomy. A small portion was intentionally left in the jugular foramen to preserve the intact eleventh cranial nerve, internal jugular vein, and sigmoid sinus. Surgical pathology confirmed glomus paraganglioma. Postoperative radiation was strongly recommended, but the patient was lost to follow-up due to the COVID-19 pandemic. The patient re-presented in late 2021 with worsened dysphonia and dysphagia. Exam confirmed left true vocal fold immobility consistent with vagal nerve paralysis and a new finding of left tongue weakness consistent with hypoglossal nerve injury. MRI revealed recurrence of the lesion to dimensions larger than original presentation and complete occlusion of the sigmoid-jugular system. Hearing and facial nerve function remained fully intact, thus a transjugular approach with hearing preservation and complete surgical resection was utilized. After combined retrosigmoid and transcervical incision, the transjugular approach was utilized to resect the sigmoid sinus, the tumor of the jugular foramen, and the intracranial extension. The ear canal and facial nerve canal were preserved. The sigmoid sinus was ligated with surgical clips and the jugular vein was ligated with suture thread. Intracranially, the hypoglossal nerve was identified and preserved, and the vagus nerve was seen eroded by tumor. Pathology confirmed recurrent paraganglioma. Postoperatively, the patient recovered well but continues to endorse persistent dysphonia. His treatment plan includes radiation and thyroplasty. Multiple surgical approaches for the treatment of skull base paragangliomas have been reported including infratemporal types A to D, among others. This report identifies a rare case of recurrent paraganglioma which necessitated removal via transjugular approach. While uncommon in skull base surgery, this approach allowed identification and preservation of important neck and skull base structures (e.g., facial nerve, ear canal, spinal accessory nerve) while achieving complete gross resection. Radiation techniques have become popular alternatives for treatment of glomus tumors of the skull base due to high levels of surgery-related adverse events. Thus, skull base surgeons should be aware of the utility of the transjugular surgical technique for patients with intact hearing and facial nerve function who seek removal of intracranial jugular foramen tumors.

Development and Validation of a Respiratory-Responsive Vocal Biomarker-Based Tool for Generalizable Detection of Respiratory Impairment: Independent Case-Control Studies in Multiple Respiratory Conditions Including Asthma, Chronic Obstructive Pulmonary Disease, and COVID-19.

BACKGROUND: Vocal biomarker-based machine learning approaches have shown promising results in the detection of various health conditions, including respiratory diseases, such as asthma. OBJECTIVE: This study aimed to determine whether a respiratory-responsive vocal biomarker (RRVB) model platform initially trained on an asthma and healthy volunteer (HV) data set can differentiate patients with active COVID-19 infection from asymptomatic HVs by assessing its sensitivity, specificity, and odds ratio (OR). METHODS: A logistic regression model using a weighted sum of voice acoustic features was previously trained and validated on a data set of approximately 1700 patients with a confirmed asthma diagnosis and a similar number of healthy controls. The same model has shown generalizability to patients with chronic obstructive pulmonary disease, interstitial lung disease, and cough. In this study, 497 participants (female: n=268, 53.9%; <65 years old: n=467, 94%; Marathi speakers: n=253, 50.9%; English speakers: n=223, 44.9%; Spanish speakers: n=25, 5%) were enrolled across 4 clinical sites in the United States and India and provided voice samples and symptom reports on their personal smartphones. The participants included patients who are symptomatic COVID-19 positive and negative as well as asymptomatic HVs. The RRVB model performance was assessed by comparing it with the clinical diagnosis of COVID-19 confirmed by reverse transcriptase-polymerase chain reaction. RESULTS: The ability of the RRVB model to differentiate patients with respiratory conditions from healthy controls was previously demonstrated on validation data in asthma, chronic obstructive pulmonary disease, interstitial lung disease, and cough, with ORs of 4.3, 9.1, 3.1, and 3.9, respectively. The same RRVB model in this study in COVID-19 performed with a sensitivity of 73.2%, specificity of 62.9%, and OR of 4.64 (P<.001). Patients who experienced respiratory symptoms were detected more frequently than those who did not experience respiratory symptoms and completely asymptomatic patients (sensitivity: 78.4% vs 67.4% vs 68%, respectively). CONCLUSIONS: The RRVB model has shown good generalizability across respiratory conditions, geographies, and languages. Results using data set of patients with COVID-19 demonstrate its meaningful potential to serve as a prescreening tool for identifying individuals at risk for COVID-19 infection in combination with temperature and symptom reports. Although not a COVID-19 test, these results suggest that the RRVB model can encourage targeted testing. Moreover, the generalizability of this model for detecting respiratory symptoms across different linguistic and geographic contexts suggests a potential path for the development and validation of voice-based tools for broader disease surveillance and monitoring applications in the future.

The Adaption to Online Synchronous Teaching and Voice Fatigue: Acoustic and Clinical Data.

At the onset of the COVID-19 pandemic in 2020, educators around the world suddenly shifted to online teaching., In 2021, we presented research on the impact of this new professional reality on the vocal load of Saint Petersburg State University professors. The online synchronous teaching caused the significant increase in the vocal fatigue in university professors in comparison with the prepandemic studies. We continued our study during the postpandemic semester (winter-spring 2022). The goal of this study was to find out whether adaptation mechanisms during the pandemic period were developed to adjust to the different types of teaching modes. The acoustic and clinical data from the pre/post comparative study are now presented.

[A CASE OF INDUCIBLE LARYNGEAL OBSTRUCTION UNSUCCESSFULLY TREATED AS SEVERE ASTHMA WAS WELL CONTROLLED AFTER APPROPRIATE DIAGNOSIS AND INSTRUCTION OF THERAPEUTIC BREATHING MANEUVERS].

BACKGROUND: Inducible laryngeal obstruction (ILO) refers to respiratory disorders caused by airflow limitation in the larynx, including vocal cord dysfunction, and may sometimes be misdiagnosed as bronchial asthma (BA). Here, we report the case of an 11-year-old boy diagnosed with BA in infancy. He was referred to our Allergy Center and was taking a high dose of inhaled corticosteroids (ICS) due to frequent coughing from the age of 10 years and persistent coughing following COVID-19 infection at the age of 11. However, the patient continued to experience frequent coughing attacks and repeated visits to the emergency department after inhalation of ß2-stimulants failed to improve his cough. We admitted him to the allergy center for examinations to assess the BA severity. In the airway hypersensitiveness test, saline inhalation performed prior to methacholine inhalation caused expiratory stridor and respiratory distress in the larynx, which worsened with ß2-stimulant inhalation. Based on these results, we ruled out BA and diagnosed ILO. We instructed him on breathing maneuvers, and he was able to respond appropriately when symptoms appeared. We then started reducing his ICS dose.