Subject(s)
Cochlear Implants , Deafness/rehabilitation , Adult , Clinical Trials as Topic , Deafness/diagnosis , Humans , MaleABSTRACT
Surgical intervention to remove vocal cord lesions usually results in normal vocal cord quality postoperatively. However, some patients exhibit persistent hoarseness after surgery, and often they are referred to a speech pathologist for vocal rehabilitation. In this study, factors were identified in the case histories, surgical management, and behavior during voice rest of patients who experienced persistent hoarseness postoperatively. Eight of ten adult subjects were interviewed and their voices were tape-recorded before and after surgery and were determined to be hoarse postoperatively. Cumulative medical history was the only significant factor that related to persistent hoarseness. Medical histories of disease or infection affecting the respiratory tract were among the specific factors that were identified. Results indicate that patients with these medical factors should be counseled about the risk of persistent hoarseness after surgery.
Subject(s)
Hoarseness/etiology , Laryngeal Diseases/surgery , Polyps/surgery , Postoperative Complications , Vocal Cords/surgery , Adult , Aged , Female , Humans , Laryngeal Neoplasms/surgery , Male , Middle Aged , Voice QualityABSTRACT
The English literature on the incidence of nystagmus in normal subjects and in patients with head and/or neck injuries is reviewed. The authors present a series of 202 patients with alleged vestibular trauma. The incidence of spontaneous and positional nystagmus would seem to be no greater in patients with alleged vestibular trauma than that found in the normal subjects, suggesting that these patients do not have objective evidence of vestibular trauma. Objective criteria for diagnosing vestibular abnormalities by electronystagmography are presented. At least 22% of a series of 2408 patients were found to have a functional hearing loss. The importance of looking for functional overlay in patients involved in litigation cases is stressed.
Subject(s)
Ear, Inner/injuries , Electronystagmography , Expert Testimony/legislation & jurisprudence , Nystagmus, Pathologic/etiology , Vestibule, Labyrinth/innervation , Adolescent , Adult , Aged , Aged, 80 and over , Caloric Tests , Female , Humans , Male , Middle AgedABSTRACT
In 23 patients with laryngotracheal trauma at the Louisville General Hospital during a ten-year period, 19 survived. One death was directly atributable to the airway injury. The most common postinjury complication was hoarsensess attributable to direct injury to the cords or recurrent nerve paralysis. One patient had further operation for subglottic stenosis. In general, blunt injuries were more severe than penetrating injuries. Subcutaneous emphysema, aphonia or dyshonia, hemoptysis, signs of injuries, a sucking wound, are presumptive findings of laryngotracheal injury. Appropriate endoscopy and radiographic studies should confirm the diagnosis. Control of the airway is achieved by emergency tracheostomy or intubation followed by tracheostomy. Prompt operative intervention and primary repair follow.
