Results of Early Versus Intermediate or Delayed Voice Therapy in Patients With Unilateral Vocal Fold Paralysis: Our Experience in 171 Patients.

OBJECTIVES: Vocal fold paralysis can have an important impact on a patient's quality of life. The goal of this study was to compare, in terms of vocal improvement and motility recovery, the post-vocal treatment results of our patients with unilateral vocal fold paralysis (UVFP) when treatment was started early (within 4 weeks from injury) versus intermediate (from 4 to 8 weeks) or delayed (at least 8 weeks after injury) treatment. STUDY DESIGN: An 11-year retrospective study of patients with UVFP who underwent multidimensional diagnostic-therapeutic assessment. METHODS: In total, 171 patients with UVFP were included in our study, divided into three groups who underwent early (first group), intermediate (second group), or delayed (third group) voice treatment. All patients underwent voice therapy based on forcible exercises supplemented by manipulations and maneuvers. RESULTS: Of the 171 patients with UVFP, 106 (62%) recovered vocal fold motility. Of these 106 patients, 51/78 (65%) were in the first group, 30/49 (61%) in the second group, and 25/44 (56%) in the third group. A significant (P < 0.0001) reduction in fundamental frequency (Fo) was present in the first group with a manifest improvement in the mean values of Jitter (Jitt%; P = 0.001), Shimmer (Shim%; P < 0.0001), and noise-to-harmonic ratio (NHR; P < 0.0001). A significant (P < 0.0001) reduction in Fo was found in the second group with a manifest improvement in Jitt% (P < 0.001), Shim% (P < 0.0001), and NHR (P < 0.0001). For the third group, no values were statistically significant apart from the improvement in NHR (P < 0.001). CONCLUSIONS: This study confirms the importance of early rehabilitation underlining the non-functional vocal recovery in patients who started treatment later than 8 weeks after injury.

Band diagram of spin waves in a two-dimensional magnonic crystal.

The dispersion curves of collective spin-wave excitations in a magnonic crystal consisting of a square array of interacting saturated nanodisks have been measured by Brillouin light scattering along the four principal directions of the first Brillouin zone. The experimental data are successfully compared to calculations of the band diagram and of the Brillouin light scattering cross section, performed through the dynamical matrix method extended to include the dipolar interaction between the disks. We found that the fourfold symmetry of the geometrical lattice is reduced by the application of the external field and therefore equivalent directions of the first Brillouin zone are characterized by different dispersion relations of collective spin waves. The dispersion relations are explained through the introduction of a bidimensional effective wave vector that characterizes each mode in this magnonic metamaterial.

Splitting of spin excitations in nanometric rings induced by a magnetic field.

We present a Brillouin light scattering investigation of the eigenmode spectrum of nanometric permalloy rings as a function of the applied magnetic field. In particular, different splitting effects induced by the applied magnetic field on the radial and azimuthal excitations have been observed and explained in terms of either mode localization or symmetry. The dynamical matrix approach has been used to calculate the whole set of eigenvectors and eigenvalues of the system, in both the vortex and saturated states.