164 research outputs found
Voice quality after carbon dioxide laser and conventional surgery for T1A glottic carcinoma
No full textThe different types of small vocal fold tumor therapy allow the preservation of respiration and deglutition; the quality of phonation is the most important criterion for the patient. The aim of the study is to compare vocal function after treatment of T1a tumors by conventional and laser cordectomy. Fifty-seven male patients were included in the study: twenty-seven underwent conventional cordectomy using an external approach, thirty underwent an endoscopic microscopic laser cordectomy. Videolaryngoscopy was performed for each subject and the maximal phonation time was measured. Spectrograms were recorded and a perturbation analysis was performed if a clear harmonic structure was visible. Voices were perceptually rated by two experienced phoniatricians using the GRBAS scale.
Even though a slightly better voice was found after conventional surgery throughout the data, no statistically significant difference was measured in the two groups. The data on voice outcome per se do not indicate the selection of one surgical approach over another
Differential expression and topography of adhesion molecules in laryngeal and oropharyngeal carcinomas
No full textSupracricoid laryngectomy : age influence on long-term functional results
No full textObjectives/Hypothesis: Supracricoid laryngectomies
(SCL) are conservative surgical techniques for
the treatment of selected laryngeal carcinomas, currently
adopted also in old patients. Long-term functional
results have not been reported in elderly
patients. The aim of this study is to compare voice
and swallowing in elderly and younger patients following
SCL.
Study Design: Cross-sectional study.
Methods: Twenty male patients who underwent
SCL were recruited in the study; 10 were younger
than 65 years at the time of surgery and 10 were
older. Video-endoscopic ratings were taken of neoglottic
vibration patterns and bolus transit. Voices were
perceptually rated using the GIRBAS scale. The maximum
phonation time (MPT) and the syllables diadochokinesis
were measured. Spectrograms were
recorded. All of the patients completed a self-assessment
questionnaire for both voice and swallowing.
The data obtained from the two groups were compared
through the Mann-Whitney test.
Results: Video-endoscopic ratings of neoglottal
vibration and bolus transit showed no difference
between the two groups. The perceptual assessment
showed a harsh voice in both groups. No significant
difference was found for mean syllable diadochokinesis
and the mean MPT was 6.3 seconds and 8.8 seconds,
respectively in the younger and older group.
The mean value of the Yanagihara scale of voice spectrogram
was 3.8 and 3.7. Voice and swallowing quality-
of-life questionnaires revealed satisfied patients in
both age groups.
Conclusions: Age by itself does not have a significant
impact on long-term functional results following
SCL. Meticulous selection of the candidate to SCL
allows the application of this surgical technique with
adequate long-term functional results
Swallowing disorders : management data
No full textAim of the investigation was to assess the workload and verify the results of oropharyngeal dysphagia management in a large state hospital by means of a descriptive, observational prospective study and descriptive statistical analysis. 81 patients [37 females, 44 males, mean age 61.3 (+/- 13) years] suffering from oropharyngeal dysphagia were evaluated and treated in the in- and outpatient Divisions of the "Azienda Ospedaliera S. Giovanni Battista" in Turin. Treatment of oropharyngeal dysphagia included changes in consistency and texture of food, compensatory postures of head, strengthening exercises for oropharyngeal muscles, and stimulation of pharyngeal sensitivity. In data collection and analysis, the following were used as outcome measures: mode of nutrition delivery (oral, enteral, parenteral), dietary adjustments, presence of aspiration or penetration, and use of compensatory head positioning. Results showed that the number of patients fed by parenteral or enteral tube (50/81 prior to treatment) dropped to 36/81 upon discharge from hospital. Those unable to take anything by mouth, from 55 dropped to 9. The number of patients with aspiration or penetration dropped, respectively, from 47 and 8 to 20 and 4. Postural changes were used in 15 cases. Data obtained indicate that oropharyngeal dysphagia rehabilitation outcomes are promising. Better understanding of the rheological characteristics of food and a stricter, more rigorous evaluation of the outcomes on activities and social participation are warranted
Intensity and fundamental frequency control in tracheoesophageal voice
No full textNowadays tracheoesophageal (TE) voice prostheses after total laryngectomy are widely used. Data on maximum phonation time and spectrum have been studied by different authors and are well known. On the contrary intensity and fundamental frequency (Fo) control have not received much attention. Intensity and Fo have an important role in the prosodic aspects of speech. Fo variations have been studied in tone language speakers, but the ability to voluntarily change intensity and Fo have been little investigated so far. The aim of study is to analyze the ability of TE voice users to change intensity and Fo.
Twelve male subjects who underwent total laryngectomy, in whom a TE prosthesis was inserted, were considered. Maximum phonation time (MPT) was calculated. Each subject was asked to utter an /a/ as loud as possible and an /a/ as soft as possible. Each subject was then asked to utter an /a/ at comfortable pitch and than at an interval of a fifth. Intensity as well as Fo variations were compared with Wilcoxon signed rank test. Correlation between MPT and variation in intensity and in Fo as well as between these two last variables was calculated through Spearman’s rank correlation coefficient.
Mean MPT was 8 (± 3.8) sec. Mean energy was 50 (±4.8) dB SPL for soft phonation and 68 (±4.7) dB SPL for loud phonation. The difference observed was statistically significant (p < 0.02). Mean Fo values were 106 (±14) Hz and 135 (±34) Hz at the interval of a fifth. The difference observed was statistically significant (p < 0.02). TE voice users were able to change intensity and Fo, but their control was rather poor. Variations in intesity as well as Fo did not show any correlation with MPT, nor they correlated between each other. In conclusion TE voice allows small Fo variations, but their control appears difficult. On the contrary intensity variations appear larger and the control somewhat easier
Women show worse control of type 2 diabetes and cardiovascular disease risk factors than men: Results from the MIND.IT Study Group of the Italian Society of Diabetology.Nutr Metab Cardiovasc Dis. 2012 Mar 5. [Epub ahead of print]
No full textHLA and type 1 diabetes: a prospective study of all new cases diagnosed in Piedmont one year
No full textLa chirurgia del neurinoma dell'acustico. Indicazioni nella scelta dell'approccio translabirintico o retrosigmoideo
No full text- …
