China
Africa
Explore chapters and articles related to this topic
Otorhinolaryngology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Chris Jephson, C. Martin Bailey
The aim of treatment is to maintain a good airway and adequate voice while awaiting spontaneous remission without causing long-term scarring of the larynx. This is achieved by ‘debulking’ the papillomas on a regular basis. Powered instruments (“microdebrider”) have superseded CO2 laser vaporisation as the treatment of choice as this causes less laryngeal scarring. Current adjunctive therapies include intralesional cidofovir, which remains controversial but has proved useful in florid disease. Tracheostomy is occasionally necessary in severe cases, but tends to cause tracheobronchial spread of papillomas and so should be avoided if at all possible.
Control of Respiratory Muscles During Speech and Vocalization
Published in Alan D. Miller, Armand L. Bianchi, Beverly P. Bishop, Neural Control of the Respiratory Muscles, 2019
Takashi Sakamoto, Satoshi Nonaka, Akihiro Katada
The most primitive and important function of the larynx is its gating mechanism to prevent the entrance of a foreign body into the lower airway. It is known that the vocal cords are closed tightly during coughing, sneezing, vomiting, and swallowing (see Chapters 18, 19, and 20). In addition, the larynx has a respiratory function. In cats and resting human subjects, the vocal cords separate fairly widely during inspiration and partially come together during expiration.15,16,24 However, electromyographic activities of the intrinsic laryngeal muscles are still controversial. The laryngeal abductor muscle posterior cricoarytenoid (PCA) in humans during quiet breathing has yielded varied activity.21,35,46 According to the activities of the adductors of the vocal cords during quiet breathing, results differ depending on the experimental conditions. Using anesthetized animals, some investigators have recorded phasic EMG activity during expiration,23,42 while others have reported little or no activity during expiration.56 Unanesthetized cats show little adductor activity during expiration.48,49 The neural origin of laryngeal breathing movements is not completely understood but is closely associated with groups of neurons in the medulla and pons that constitute the central respiratory control mechanism (described in Chapters 7 and 10).
Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The larynx is a cartilaginous structure made up of the thyroid cartilage, epiglottic cartilage, cricoid cartilage, and arytenoid cartilages (Plates 3.43 and 3.44; described in detail in Section 3.2.3). The thyroid cartilage, formed of two thyroid laminae, superior horns, and inferior horns and connected to the hyoid bone superiorly by the thyrohyoid membrane, is the largest of these cartilages. Inferior to the thyroid cartilage and connected to it by the cricothyroid joints is the cricoid cartilage, composed of the cricoid lamina and cricoid arch. The thyroid and cricoid cartilages form a hollow tube and the epiglottic and arytenoid cartilages lie within. The epiglottic cartilage is suspended by its stalk from the thyroid laminae, whereas the arytenoid cartilages are attached to the cricoid cartilage by synovial joints and by the vocal ligament attached to the vocal process of the arytenoid cartilage.
Arytenoid cartilage necrosis due to prolonged endotracheal intubation: A case report of conservative follow-up with variable endoscopic findings
Published in Acta Oto-Laryngologica Case Reports, 2023
Akihisa Tanaka, Takashi Masui, Hirokazu Uemura, Tadashi Kitahara
A 46-year-old man presented with hoarseness and a slight wheeze 5 days after extubation. He had undergone surgery for a Stanford A acute aortic dissection and required 4 days of postoperative endotracheal intubation with an 8-mm internal diameter endotracheal tube. He did not have any medical comorbidities except for that vascular disease and hypertension. His height, weight, and body mass index were 169 cm, 65 kg, and 22.8 respectively. The patient’s maximum phonation time was 4 s, which suggested laryngeal pathology (in the absence of pathology, many healthy adults can phonate beyond 20 s) [3]. Necrotic tissue and an ulcer were observed endoscopically on the surface of the bilateral posterior glottic region, including the AC. The VCs had lost almost complete mobility (Figure 1). The larynx had diffuse inflammation with redness and oedema. Computed tomography (CT) imaging showed a partially missing AC with a peripheral abscess. We diagnosed the patient with ACN (Figure 2). However, we did not perform a tracheostomy because the posterior glottic chink was fortunately confirmed and percutaneous oxygen saturation remained high without supplementation.
Incidence of head and neck cancer among first-generation immigrants and their children in Finland
Published in Acta Oncologica, 2023
Rayan Mroueh, Elli Hirvonen, Janne Pitkäniemi, Nea Malila, Jaana Hagström, Antti Mäkitie, Anni Virtanen
Our results suggest that female first-generation immigrants have a reduced risk of HNC compared with the female general population. Although only female immigrants from Europe were noted to have a significantly lower occurrence of HNC, there appeared to be a comparable incidence decrease also among immigrants from other regions, even if not statistically significant, suggestive of a ‘healthy immigrant effect’. First-generation immigrant men had an overall HNC incidence rate similar to the incidence reported for the general male population of Finland. However, we observed higher risks for selected infection- and tobacco-related cancers, i.e., pharynx and larynx, especially in the 50–64 and 65–79-year age groups. This could affect diagnostics in patients presenting with symptoms and enhance early detection of the disease. Efforts to address the main etiological risk factors are needed among the selected immigrant populations, that haven’t yet reached similar decreasing trends, as in for example smoking, as the main population [25,49]. Moreover, future studies on the access to and use of health services among immigrants are warranted.
Acoustic parameter changes after bariatric surgery
Published in Logopedics Phoniatrics Vocology, 2022
Fakih Cihat Eravci, Barış Doğu Yildiz, Kürşat Murat Özcan, Münevver Moran, Mustafa Çolak, Süleyman Emre Karakurt, Mehmet Fatih Karakuş, Aykut Ikinciogullari
The voice is used as a vital tool for communication and is another fingerprint in social life representing the individual with its unique characteristics, and many use the voice in professional life. The voice is produced by the larynx with the motor power of airflow generated by the lungs. After the production of the voice, all the upper levels of the airway path contribute to the acoustic characteristics. Therefore, the supralaryngeal vocal tract size and configuration is a determinative factor in the features of the voice [6]. Changes in any part of the voice production process (i.e. the lung capacity, laryngeal tract, and supralaryngeal vocal tract) result in differences in voice characteristics. Changes in the length and shape of the vocal tract, or height and position of the tongue can result in changes especially in formant frequencies in the acoustic analysis [7].