ABSTRACT
OBJECTIVES: To compare respiratory function, swallowing and voice quality of bilateral abductor vocal fold paralysis (BAVFP) patients undergoing laser and diathermy-assisted posterior cordotomy. DESIGN: Prospective study. SETTING: Tertiary academic hospital. PARTICIPANTS: Thirty patients were included in the study (groups 1 and 2, 15 patients each). Mean age was 53 ± 14.27 years with a range of 31-78 years (12 [40%] males, 18 [60%] females). MAIN OUTCOME MEASURES: Sufficient airway, complications, FEV1, FEV1/FVC, peak expiratory flow rate (PEF), voice quality VAS, fundamental frequency, jitter, shimmer, NHR, amplitude perturbation quotient (APQ) and pitch perturbation quotient (PPQ) scores. RESULTS: A sufficient laryngeal airway was achieved in all patients. Six patients (20%) developed postoperative granulation tissue (2 in group 1 and 4 in group 2). There was a statistically significant improvement in FEV1, FEV1/FVC and PEF measurements at the postoperative sixth month compared to preoperative measurements in both of the groups (P < .05). Preoperative median voice quality VAS scores in groups 1 and 2 were 8 (IQR = 1) and 8 (IQR = 3), respectively. Postoperative sixth-month voice quality VAS scores in groups 1 and 2 were 6 (IQR = 1) and 6 (IQR = 0), respectively. Postoperative VAS scores were significantly lower in both groups (P < .05). The postoperative changes in fundamental frequency, NHR, jitter, shimmer, APQ and PPQ were not statistically significant in both of the groups (P > .05). CONCLUSIONS: Laser and diathermy-assisted posterior cordotomy are both minimally invasive, effective techniques with a long-term sufficient laryngeal airway. Despite lower quality of voice VAS scores, objective acoustic outcomes were not significantly lower in both of the groups.
Subject(s)
Cordotomy/methods , Diathermy/methods , Vocal Cord Paralysis/surgery , Vocal Cords/surgery , Voice Quality/physiology , Adult , Aged , Deglutition/physiology , Female , Follow-Up Studies , Humans , Laryngoscopy/methods , Male , Middle Aged , Prospective Studies , Treatment Outcome , Vocal Cord Paralysis/physiopathology , Vocal Cords/physiopathologySubject(s)
Benzamides , Brain/diagnostic imaging , Pyrrolidines , Receptors, Dopamine/analysis , Tomography, Emission-Computed, Single-Photon/methods , Antipsychotic Agents/pharmacology , Antipsychotic Agents/therapeutic use , Benzamides/metabolism , Brain/metabolism , Brain Chemistry/drug effects , Female , Humans , Male , Psychiatric Status Rating Scales , Pyrrolidines/metabolism , Receptors, Dopamine/drug effects , Receptors, Dopamine/metabolism , Schizophrenia/drug therapy , Schizophrenia/metabolism , Schizophrenic PsychologyABSTRACT
Postgraduate education for medical librarians is approachable from several perspectives, including internships, certificate programs, and continuing education programs. The diverse population of medical library personnel calls for a varied yet coordinated system of postgraduate education involving the Medical Library Association, regional medical libraries, library schools, and the National Library of Medical, in addition to active participation by all librarians in the health sciences field. Basic philosophies for each of the major types of programs are discussed and recommendations for future training of health sciences librarians are provided.
