Voice evaluation before and after laser excision vs. radiotherapy of T1A glottic carcinoma.

Quality of voice after treatment for T1A glottic squamous cell carcinoma was studied in two matched groups of males treated either with CO2 laser cordectomi (n = 18, mean age 65.2 years) or with full dose radiotherapy (n = 18, mean age 65.1 years). All patients had histologically verified invasive squamous cell carcinoma. Fifteen male patients (mean age 63.9 years) without laryngeal disorders were used as controls. Voice recordings prior to treatment, and both at 3 months and at 2 years after completed treatment were analyzed. Acoustic measures of shimmer, jitter, breathiness, harmonic-to-noise ratio and fundamental frequency (F0) average were calculated with the Soundscope program. Two plain measures were also used: time required to read a running speech voice sample, and number of breaths. Perceptual voice analysis was performed blindly by two groups of listeners, Group A (4 experienced listeners) and Group B (4 naive listeners). Group A estimated quality of voice according to a modified GRBAS score, whereas Group B estimated Grade only. We found voice quality both at 3 months and at 2 years after radiotherapy to be significantly better than after laser treatment, as assessed by the acoustic variables breathiness, jitter, F0 average, running speech voice sample reading time and number of breaths. The perceptual variables Grade (Group A and B), Breathiness, Asthenia and Strain were also significantly better after radiotherapy.

Acoustic analysis of functional dysphonia: before and after voice therapy (accent method).

Ten patients who were referred to a speech pathologist for functional voice disorders were treated with voice therapy using the accent method. The vocal folds were normal except in three females who had moderate bilateral nodules. The voices were analyzed acoustically before and after treatment. Of the parameters tested, pitch perturbation quotient, amplitude perturbation quotient, normalized noise energy for 1-4 kHz, and fundamental frequency showed significant improvement.

Acute laryngitis in adults: results of erythromycin treatment.

Previous studies of acute laryngitis in adults have shown high nasopharyngeal isolation rates of B. catarrhalis and H. influenzae. Phenoxymethylpenicillin had no effect on the clinical course. In the present study, 106 patients with acute laryngitis were treated with erythromycin 0.5 g x 2 V or placebo. During the first week the isolation rate of B. catarrhalis was reduced from 60 to 10% in the erythromycin group compared to 34 to 27% in the placebo group (p less than 0.01). The elimination of H. influenzae, isolated in 19% at the acute visit, did not differ between the two groups. As compared to controls, erythromycin treated patients reported significantly lower scores of subjective voice disturbance after 1 week and cough after 2 weeks. Laryngological examination and voice evaluation failed to reveal any differences between the groups.

Pathogenesis of idiopathic contact granuloma of the larynx. Results of a prospective clinical study.

The pathogenesis of idiopathic contact granuloma is still not clear. The present results of a prospective study on possible etiological factors indicate that oesophageal disturbances are common in patients with contact granuloma but some other pathogenetic factors must also be considered.

Carbon dioxide laser as primary treatment of glottic T1S and T1A tumours.

A series of 31 glottic T1 tumours, 18 T1A and 13 T1S, treated endoscopically by carbon dioxide laser surgery is presented. There were 3 recurrences in each group which were successfully treated by repeated laser surgery or radiotherapy. A comparison of the quality of the voice with T1A tumours primarily treated by radiotherapy using a GRBAS score is made. The quality changed for the worse permanently after laser excision.

Inefficacy of penicillin V in acute laryngitis in adults. Evaluation from results of double-blind study.

Patients with acute laryngitis following an upper respiratory tract infection are often treated with antibiotics for their voice complaints, although, to our knowledge, the effect of such therapy has not been examined. In the present study, comprising 100 adults with laryngitis, the rate of resolution of vocal symptoms, as estimated from voice recordings or subjectively by the patients, was the same in patients who received penicillin V (pcV) as in those who received placebo. Similarly, the degree of rhinorrhea/nasal congestion and cough was not significantly influenced by pcV treatment. At the acute visit, nasopharyngeal cultures revealed Branhamella catarrhalis in 50%, Hemophilus influenzae in 15% and Streptococcus pneumoniae in 1% of the patients; the rate of elimination of these bacteria was the same in the pcV as in the placebo group. Thus, while suggesting that B catarrhalis and H influenzae are important for the pathogenesis of the disorder, our results do not provide support for the use of pcV in acute laryngitis.

Vocal effects of danazol therapy. A preliminary report.

Vocal effects of danazol therapy were studied in 23 women. Before danazol therapy was started the patients were examined by a phonitrician using indirect laryngoscopy and microlaryngoscopy in stroboscopic light. A glottographic frequency indication ad modum Kitzing and a tape-recording were also made. These examinations were carried out again after 3 and 6 months of therapy. The patients mostly received 600 mg danazol daily. One of the patients noticed a very marked change in her voice after 2 weeks of therapy. This patient also had conjunctivitis and the reaction was judged to be an allergic reaction to the drug and not a hormonal side effect. In 4 of the other 22 patients the glottographic frequency indication showed a slight decrease in the mean frequency and in 3 a slight increase within the normal range of interpersonal variation. None of the patients noticed subjectively any virilization of the voice. In this preliminary study we have not found any significant vocal changes in the 23 patients tested that could be attributed to the androgenic properties of danazol.

Dyspraxia of speech and of eye motility.

Five patients with a disturbance of their preprogramming of speech (dyspraxia of speech) were exposed to a comprehensive eye-motor test-battery. The saccades were found hypometric and inaccurate with irregular intervening pauses. The finding was interpreted as due to an extension of lesions from frontal cortical speech areas into visual motor cortex disturbing the normal preprogramming of voluntary saccades. The results were interpreted as supporting the assumption that voluntary saccades are initiated in the frontal cortex. An increase of vestibular nystagmus in these cases was related to a release of vestibular nystagmus due to the disappearance of cortical inhibition on brain stem acitivty.