ABSTRACT
OBJECTIVE: Dysfunctional breathing often coexists with asthma and complicates asthma control, especially in difficult-to-treat asthma. Voice bubbling therapy (VBT) by a specialized speech therapist may influence the breathing pattern. This pilot study investigated the effect of voice bubbling therapy (VBT) in participants with difficult-to-treat asthma, who fulfilled criteria for dysfunctional breathing pattern. METHOD: Twenty-four patients were randomized between VBT and usual care (UC). VBT is blowing into a glass (resonance) tube (28 cm in length, 0.9 cm inner diameter) which ends in a bowl of water (1.5 litre). Lung function, capillary blood gas and questionnaires were measured at baseline, at 6 and 18 weeks of follow up. RESULTS: No difference in ACQ and quality of life was found after VBT compared to UC group. However, after six weeks of bubbling therapy, pCO2 levels measured in capillary blood gas were higher (baseline median (IQR) pCO2 = 33.00 (17.25 - 38.6) mmHg; week 6 pCO2 = 36.00 (29.00 - 42.3) mmHg) p = 0.01. Moreover, ΔpCO2 (baseline - 18 weeks of follow up) was significantly correlated with ΔAQLQ (rs = 0.78, p = 0.02). CONCLUSION: VBT in participants with difficult-to-treat asthma resulted in a higher average pCO2 level, indicating the treatment may improve hyperventilation. However, this did not improve asthma control or quality of life. VBT may have value for a better management of asthma related symptoms.
Subject(s)
Asthma , Vocal Cord Dysfunction , Asthma/diagnosis , Humans , Hyperventilation , Pilot Projects , Quality of LifeABSTRACT
A 33-year-old male singer presented with a vocal fold polyp, a 20-year-old female singer with vocal fold submucosal bleeding, and an 18-year-old female singer with early vocal fold nodules. The vocal fold polyp was removed surgically. In the second patient vocal fold nodules were visible after resorption of the blood; they were removed surgically. The third patient was treated conservatively. A professional singer with a voice problem should be examined by an ear, nose, and throat surgeon with a special interest in disorders of the professional voice. After surgical treatment of voice problems, enough rehabilitation time should be taken for optimal recovery. Agreement about resting and rehabilitation of the voice and careful planning of the return to the stage are essential. If the singer is famous it is important that the doctor should resist the pressure exerted by management and media.
Subject(s)
Laryngeal Diseases/surgery , Occupational Diseases/surgery , Polyps/surgery , Vocal Cords/pathology , Voice Disorders/prevention & control , Voice Disorders/surgery , Adolescent , Adult , Female , Humans , Male , Music , Treatment Outcome , Voice Quality , Young AdultABSTRACT
An unilateral maxillary sinusitis is frequently caused by dental pathology. An odontogenic cyst in the maxillary sinus usually lacks accompanying symptoms of infection. In three patients, a 35-year-old man and two women aged 16 and 28, an odontogenic cyst in the maxillary sinus was diagnosed. Consultation of a maxillofacial surgeon is needed because orthopantomographic imaging is diagnostically most helpful. In these patients combined treatment by an ENT surgeon and a maxillofacial surgeon is important.
