RESUMEN
AIMS: To assess whether individual voice range profile parameters or combinations of these are able to yield a clear cluster separation of male voices. METHODS: The voice range profiles of 256 male conservatory singing students and professional singers were recorded, parameterized into more compact descriptions ('features'), and subjected to a cluster analysis. RESULTS: Based on all parameters the frequency dip of the register transition zone was shown to yield the best cluster separation for three basic male voice types. CONCLUSIONS: This study demonstrates that parameter combinations of the voice range profile exist that generate a clear separation of voice clusters. This was also the case with female voices as shown in a former study. The clusters may be attributed to the three classic basic male voice types, and in this way our results can provide a fresh angle on the issue of male voice classification.
Asunto(s)
Discriminación en Psicología , Percepción de la Altura Tonal , Canto , Acústica del Lenguaje , Calidad de la Voz , Adolescente , Adulto , Análisis por Conglomerados , Humanos , Masculino , Persona de Mediana Edad , Espectrografía del Sonido , Adulto JovenRESUMEN
AIMS: To assess whether individual parameters or combinations of voice range profile parameters (also called 'features') are able to yield a clear cluster separation with which three basic female voice categories can be discriminated and can provide a basis for settling the issue of voice classification. METHODS: The voice range profiles of 206 female conservatory singing students were recorded, parameterized into more compact descriptions ('features'), and subjected to a cluster analysis. RESULTS: The three-cluster case provided the most consistent solution across all feature combinations. The feature that led to the best cluster separation was the ratio of the perimeter length of the chest voice part of the voice range profile versus the total perimeter length. CONCLUSIONS: Based on a statistical analysis of voice range profile parameters, the ratio of the perimeter length of the chest voice versus the total perimeter length was shown to yield a clear separation into three basic female voice types, which in turn may give us a basis for settling the issue of voice classification.
Asunto(s)
Música , Fonación , Discriminación de la Altura Tonal , Voz , Adolescente , Adulto , Clasificación , Análisis por Conglomerados , Femenino , Humanos , Caracteres Sexuales , Adulto JovenRESUMEN
OBJECTIVE: Voice handicap in relation to psychosomatic well-being after education in female student teachers. METHODS: A longitudinal survey among 90 female students using Voice Handicap Index and Symptom Check List-90 at the start and end of education. RESULTS: Student teachers in fourth grade showed lower VHI Total and lower SCL-90 Total scores compared to first grade. Students with higher VHI scores in fourth grade had higher risk on "Anxiety" (OR=1.8 to 4.8), "Agoraphobia" (OR=1.9 to 3.9) and "Insufficiency in thinking and acting" (OR=1.6 to 3.2). Students with respectively higher VHI-Total and VHI-Emotional subscale scores had higher risk on "Depression" (OR=1.7, resp. 3.9), "Interpersonal sensitivity and mistrust" (OR=1.6, resp. 3.2), "Hostility" (OR=1.7, resp. 2.1) and SCL-Total (OR=3.1 resp. 4.0). CONCLUSIONS: Student teachers at the end of education showed more well-being and were less vocally handicapped. A tendency for a positive relation between higher emotional voice handicap and more psychosomatic complaints was found. SUGGESTIONS: The VHI has proven to be useful and special attention to VHI Emotional scale is advised in screening. This study might have implications for the preventive care and a multi-dimensional approach with attention to physical, mental and social voice care in future teachers is suggested. In contrast to the group score comparisons a closer look at individual reports on specific VHI items in relation to SCL-90 may be fruitful to detect tendencies. Student teachers can benefit from interdisciplinary collaboration between a psychologist and voice therapist in reducing psychosocial risk factors.
Asunto(s)
Síntomas Conductuales , Personas con Discapacidad/psicología , Docentes , Estudiantes/psicología , Trastornos de la Voz , Síntomas Conductuales/etiología , Síntomas Conductuales/fisiopatología , Personas con Discapacidad/educación , Femenino , Humanos , Relaciones Interpersonales , Estudios Longitudinales , Grupo de Atención al Paciente , Servicios Preventivos de Salud/métodos , Pruebas Psicológicas , Psicología , Psicofisiología , Factores de Riesgo , Índice de Severidad de la Enfermedad , Estrés Psicológico/etiología , Estrés Psicológico/fisiopatología , Trastornos de la Voz/complicaciones , Trastornos de la Voz/psicología , Trastornos de la Voz/terapia , Entrenamiento de la Voz , Adulto JovenRESUMEN
OBJECTIVE: The aim of the study was to explore the general coping style of female teachers with a relatively low voice handicap compared with teachers with a relatively high voice handicap. PATIENTS AND METHODS: A cross-sectional questionnaire survey was conducted among 450 teachers using the Voice Handicap Index (VHI) and the Utrecht Coping List (UCL). A group of 400 subjects quasi-randomly selected from the general population were used as controls. RESULTS: Teachers with a relatively high voice handicap (VHI >or=75th percentile) scored lower on the UCL subscale 'active confrontation or dealing with the problem' (p = 0.001) and higher on the UCL subscale 'passive reaction pattern' (p = 0.006), compared to teachers with a relatively low voice handicap (VHI Asunto(s)
Adaptación Psicológica
, Docentes
, Trastornos de la Voz/psicología
, Adulto
, Evaluación de la Discapacidad
, Femenino
, Humanos
, Persona de Mediana Edad
, Pruebas Psicológicas
, Apoyo Social
, Encuestas y Cuestionarios
, Adulto Joven
RESUMEN
OBJECTIVE: The aim of this study was to investigate the relation between trainee experience and voice handicap, general coping and psychosomatic well-being in student teachers. METHODS: A longitudinal survey was performed among 43 starting female student teachers, becoming a professional teacher in primary education. The subjective biopsychosocial consequences of voice problems was assessed by the Voice Handicap Index inventory, the general coping style by the Utrecht Coping List and psychosomatic well-being by the Symptom Checklist. RESULTS: Student teachers in general and especially with a higher impact of the voice after two trainee periods showed a more reactive-defensive coping style. Student teachers with a higher impact of the voice after two trainee periods had less psychosomatic well-being. CONCLUSION: These findings may call for a different attitude of the (university) speech therapist. They should take into account that together with changing the voice handicap, factors of psychosomatic well-being can play an important role in coaching student teachers. Speech therapists should also be encouraged to change the student's passive coping behaviour into a more active method and to stimulate the student to implement a new coping attitude into new trainee activities.
Asunto(s)
Adaptación Psicológica , Docentes , Trastornos de la Voz/psicología , Adolescente , Evaluación de la Discapacidad , Educación Profesional , Femenino , Humanos , Estudios Longitudinales , Masculino , Pruebas Psicológicas , Encuestas y Cuestionarios , Factores de Tiempo , Adulto JovenRESUMEN
PROBLEMS/OBJECTIVES: To assess remission rate, treatment results, and factors for remission in patients with adult-onset recurrent respiratory papillomatosis (AORRP). METHODOLOGY: In this retrospective study, the clinical and pathological data of 51 patients with AORRP, treated in University Hospitals between 1972 and 2006 were reviewed. The male-female ratio was 7:3. At diagnosis, the median age was 43 years, and the median retrospective Coltrera-Derkay Staging and Severity score was 6 (range, 2-28). Twenty-one patients (41%) received only surgical treatment. Thirty patients (59%) were treated with surgery and adjuvant intralesional cidofovir. RESULTS: At the time of analysis in December 2006, 69% of the patients were in remission. Of those, 46% had been treated with adjuvant cidofovir. Of the patients who were not in remission, 87% had been treated with adjuvant cidofovir. This difference was statistically significant (p = 0.005). No significant difference was found between the remission group and the non-remission group for the factors age, gender, smoking habits, alcohol habits, GERD, severity and duration of therapy. CONCLUSIONS: AORRP was curable in most patients after long intensive treatment, with a general remission rate of 69%. Cidofovir was a negative factor for remission (p = 0.005). No other statistically significant factors for remission were found. Although a control group was present, it was not possible to perform a randomized study with comparable groups. A well-designed placebo-controlled, double-blinded, randomized trial to assess the outcomes of adjuvant intralesional cidofovir therapy for RRP would be valuable.
Asunto(s)
Antineoplásicos/uso terapéutico , Neoplasias Laríngeas/cirugía , Papiloma/cirugía , Adolescente , Adulto , Edad de Inicio , Anciano , Anciano de 80 o más Años , Antineoplásicos/administración & dosificación , Quimioterapia Adyuvante , Cidofovir , Citosina/administración & dosificación , Citosina/análogos & derivados , Citosina/uso terapéutico , Femenino , Humanos , Inyecciones Intralesiones , Neoplasias Laríngeas/tratamiento farmacológico , Neoplasias Laríngeas/epidemiología , Laringoscopía , Masculino , Recurrencia Local de Neoplasia , Organofosfonatos/administración & dosificación , Organofosfonatos/uso terapéutico , Papiloma/tratamiento farmacológico , Papiloma/epidemiología , Estudios Retrospectivos , Adulto JovenRESUMEN
BACKGROUND: Objective measurements do not evaluate the biopsychosocial impact of a voice disorder. The Voice Handicap Index (VHI) measures the influence of voice problems on a patient's quality of life. OBJECTIVE: To investigate if the VHI can monitor biopsychosocial impact of voice disorders and to provide a frame of reference for use of the VHI in general ENT practice. METHODS: VHI scores and subscores were analysed in 272 controls, 237 patients with initial voice complaints ("new patients") and 92 patients before and after microsurgery ("operated patients"). RESULTS: The VHI scores of the controls were not normally distributed (Kolmogorov-Smirnov test: < .001). The total VHI scores for the 5th, 10th, 25th, 50th, 75th, 90th and 95th percentiles were, respectively, 0.0, 0.0, 2.0, 6.0, 12.0, 23.0 and 32.8. In the controls, there was not a significant effect of gender on either VHI totals or subscores (p = 0.060-0.858). In the "new patients" group, males scored significantly higher on the functional subscore (p = 0.004). There was a very weak negative correlation between age and VHI totals and subscores in controls (correlation coefficient: -0.092 to -0.187). There was a significant difference in VHI totals and subscores between subjects with and without voice complaints (p < 0.001). In the patient group, VHI scores of professional voice users (PVUs) were not significantly different from those of non-PVUs (p = 0.112-0.753). In controls, a significantly higher score was found for PVUs in the P domain of the VHI (p = 0.017). After microsurgical treatment, 82.0% of patients had a lower total VHI score, and 93.3% reported an improvement in voice. In the patient group, the median postoperative VHI score was almost halved. CONCLUSION: Gender and profession did not have a significant influence on the total VHI score. There was a weak tendency for VHI to decrease with age. The VHI is a useful instrument for quantifying the biopsychosocial impact of a voice disorder, and is able to monitor changes in self-perception of voice handicap after treatment.
Asunto(s)
Evaluación de la Discapacidad , Calidad de Vida , Trastornos de la Voz , Calidad de la Voz/fisiología , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Trastornos de la Voz/fisiopatología , Trastornos de la Voz/psicología , Trastornos de la Voz/rehabilitaciónRESUMEN
It is generally accepted that vocal performance decreases with age. This decrease can be expected to be more pronounced in voice loading professions, which may lead to occupational dysphonia. The aim of this study was to investigate the course of voice complaints, experienced handicap, and absenteeism of work due to voice problems throughout the teaching years. Questionnaires were distributed among teachers of primary and secondary education, and 1875 were analyzed. The questionnaire was designed in such a way that personal aspects and questions about periods with symptoms and absence from work were included. The Voice Handicap Index (VHI) developed by Jacobson et al was sent along with the questionnaire. Surprisingly, a significant decrease of voice complaints during the career of the teachers was observed. The expectation that the percentage of teachers with a history of voice problems should experience more psychosocial impact, measured with the VHI, along their professional career could not be confirmed by this study. These results indicate that serious attention has to be paid to teachers with voice complaints. The fact that teachers in the beginning of their career complain more than in the end of their career emphasizes the importance of adequate aimed prevention programs for future teachers and for starting teachers with regard to their voice.
Asunto(s)
Selección de Profesión , Enfermedades Profesionales/diagnóstico , Enseñanza/métodos , Trastornos de la Voz/diagnóstico , Calidad de la Voz , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicología , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
The aim of the study was to estimate voice complaints, risk factors for voice complaints and history of voice problems in student teachers before they embarked on their professional teaching career. A cross-sectional questionnaire survey was performed among female student teachers. The response rate was 72% and 457 questionnaires were analyzed. Voice complaints at the moment and/or during the past year were reported by 39.6% subjects. Subjects with voice complaints had significantly higher VHI scores than subjects without voice complaints. In comparison to subjects without voice complaints, overall, subjects with voice complaints reported more frequently that vocal loading factors, physical factors, environmental factors and psychological factors had a negative influence on their voice. Subjects with voice complaints reported more frequently a history of voice complaints during puberty and before puberty in comparison to subjects without voice complaints. Voice complaints in student teachers apparently had a multifactorial genesis and with roots during puberty or before puberty. Logistic regression analysis revealed that intensive voice use, emotions and history of voice complaints during puberty were the most discriminating set of risk factors for voice complaints. Subjects with voice complaints in comparison to those without voice complaints reported more frequently that they would develop a voice problem due to future teaching and that future teaching would have a negative influence on their voice. Around three quarters of subjects with and without voice complaints reported that attention paid to their voice during their training was sufficient. However, subjects with voice complaints were observed to report the need for a refresher course on voice use more frequently than those without voice complaints. The findings call for more intensive voice training for student teachers to cope with the vocal, physical and psychological demands of the teaching profession. Authorities should take responsibility to monitor and improve working conditions of student teachers and teachers.
Asunto(s)
Docentes , Enfermedades Profesionales/etiología , Pubertad/fisiología , Estudiantes , Trastornos de la Voz/etiología , Adolescente , Adulto , Estudios Transversales , Emociones , Femenino , Humanos , Persona de Mediana Edad , Enfermedades Profesionales/epidemiología , Factores de Riesgo , Estrés Fisiológico , Encuestas y Cuestionarios , Factores de Tiempo , Trastornos de la Voz/epidemiologíaRESUMEN
An epidemiological cross-sectional survey study was performed among female student teachers and teachers for primary education, using a general questionnaire, the Type D Scale 16 (DS16) and Voice Handicap Index (VHI). Type D personality is the combination of high 'negative affectivity' and high 'social inhibition', and the DS16 has been considered to be a reliable and valid measure of these two stable personality traits. The objectives of the study were to assess the VHI of type D subjects in comparison to non-type-D subjects, to explore the utility of the DS16 and the VHI to assess whether subjects with a type D personality were more handicapped due to their voice complaints, and whether they behaved differently in seeking voice care. It was investigated whether subjects of the type D group in comparison to the non-type-D group had a voice handicap even when they did not report voice complaints. The type D group did not report more voice complaints than the non-type-D group. However, the type D group had higher VHI scores compared to the non-type-D group. Furthermore, significantly more type D subjects had a VHI score greater than the 75th percentile than the non-type-D subjects, and they sought less voice care than the non-type-D subjects. Also among subjects who reported voice complaints, the type D group sought less care than the non-type-D group. Even among the subjects who did not report voice complaints, significantly more type D than non-type-D subjects had VHI scores higher than the 75th percentile. The findings indicated that type D subjects were apparently more bothered by their voice than the non-type-D subjects (high VHI scores); however, they did not report more voice complaints, and they also sought less voice care. The DS16 used along with the VHI was useful to identify subjects of the type D trait with a voice handicap. This enables specific voice care, encompassing not only physical, but also psychosocial aspects of vocal health.
Asunto(s)
Determinación de la Personalidad/normas , Personalidad , Logopedia/métodos , Trastornos de la Voz/diagnóstico , Calidad de la Voz , Adulto , Bélgica/epidemiología , Distribución de Chi-Cuadrado , Estudios Transversales , Docentes , Femenino , Humanos , Prevalencia , Logopedia/normas , Encuestas y Cuestionarios , Trastornos de la Voz/epidemiología , Trastornos de la Voz/psicología , Trastornos de la Voz/terapiaRESUMEN
In order to identify factors that are associated with voice problems and voice-related absenteeism in teachers, 1,878 questionnaires were analysed. The questionnaires inquired about personal data, voice complaints, voice-related absenteeism from work and conditions that may lead to voice complaints and absenteeism. Different factors play a role in the development and consolidation of voice problems. Physical and psycho-emotional factors appear to be the most important risk factors. Remarkably, voice load and environment seem to be less important as risk factors in the development and consolidation of voice complaints. Teachers who experienced voice problems during their training reported more voice problems during their career. The results of this study stress the importance of a multifactorial approach in the diagnosis and treatment of voice problems, whereby physical and psycho-emotional aspects should be considered as sensitive to the risk of developing voice problems. Moreover, this study shows the crucial importance of adequate voice training during the teacher training programme.
Asunto(s)
Docentes/estadística & datos numéricos , Enfermedades Profesionales/etiología , Trastornos de la Voz/etiología , Absentismo , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/prevención & control , Factores de Riesgo , Medio Social , Estrés Psicológico/complicaciones , Encuestas y Cuestionarios , Trastornos de la Voz/epidemiología , Trastornos de la Voz/prevención & control , Entrenamiento de la VozRESUMEN
In order to assess voice complaints and absence from work due to voice problems among teachers of primary and secondary education, as well as among a control group, 2,117 questionnaires were analysed. The total group consisted of 1,878 teachers and 239 controls. Female teachers more frequently reported voice complaints and absence from work due to voice problems than their male colleagues. No unequivocal relationship between age on the one hand and voice complaints and absence from work due to voice problems on the other hand was observed. Therefore, the percent of cases was corrected for gender but not for age. More than half of the teachers reported voice problems during their career and about one fifth had a history of absence from work due to voice problems. These numbers are relatively high compared to those of the controls with as well as to those without a vocally demanding profession. More than 20% of the teachers sought medical help or had been treated for a voice problem. Remarkably, more than 12% of the teachers had experienced voice problems during their training and this group reported significantly more voice complaints and absence from work due to voice problems in their career than the colleagues without voice problems during the training. The results of the Voice Handicap Index scores followed these trends. These findings point at voice problems during education as a risk factor for getting voice problems during the career. The results of this study clearly demonstrate that teaching is a high-risk profession for the development of voice problems, which is in accordance with other studies and support the contention that voice is a worldwide problem in the teaching profession. Furthermore, this study indicates the importance of voice care not only during training for the profession but also during the career.
Asunto(s)
Docentes/estadística & datos numéricos , Enfermedades Profesionales/epidemiología , Trastornos de la Voz/epidemiología , Absentismo , Adulto , Estudios Transversales , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Países Bajos , Enfermedades Profesionales/etiología , Factores de Riesgo , Encuestas y Cuestionarios , Trastornos de la Voz/etiologíaRESUMEN
A cross-sectional questionnaire survey was performed to compare female student teachers (454 subjects; 1st to 4th year of training) and practicing teachers (82 female teachers; 1st to 4th year of teaching career) of primary education early in their career, with regard to risk factors perceived to be a negative influence on the voice, and the relative risk of the given risk factors for voice complaints. This enables the observation of whether there is a sudden increase or difference in the perceived risk factors after starting a professional teaching career. Additionally, the existence of a history of voice problems during training was questioned among the teachers. Teachers with voice complaints compared to teachers without voice complaints reported a history of voice complaints during their training (P =0.013). Teachers compared to student teachers reported more voice complaints at the moment and/or during the past year (P =0.002). The following data were obtained from student teachers and teachers reporting voice complaints. Only around a third of the subjects of both groups sought voice care (P =0.286-0.893). Risk factors were estimated in relation to voice complaints. Student teachers reported less frequently than teachers that stress (P =0.014), work pressure (P =0.003) and the composition of the class (P =0.013) have a negative influence on their voice. Student teachers reported less frequently than teachers that the number of people they communicate with (P <0.001) and the deterioration of their general physical condition (P =0.010) have a negative influence on their voice. Student teachers reported more frequently than teachers that environmental irritants (P <0.001) and humidity (P =0.020) of the classroom have a negative influence on their voice. Student teachers more than teachers were of the opinion that the attention paid to the voice during their training was sufficient (P <0.001). To test whether professional status (student teacher versus teacher) is an effect modifier for the risk factors, odds ratios (OR) were compared between the group of teachers and of student teachers (total group with and without voice complaints) to search for interactions between the risk factors and professional status. There is a significant difference in the pattern of risk factors for student teachers and teachers (P =0.010). There is an indication that vocal loading factors and environmental factors are more influential in student teachers and that there is a tendency for psycho-emotional factors to be more influential for teachers early in their career.
Asunto(s)
Docentes , Enfermedades Profesionales/epidemiología , Estudiantes , Trastornos de la Voz/epidemiología , Adolescente , Adulto , Estudios Transversales , Ambiente , Humanos , Persona de Mediana Edad , Estrés Psicológico/epidemiología , Estudiantes/estadística & datos numéricos , Factores de TiempoRESUMEN
The aim of this study was to investigate the relationship between extrinsic laryngeal muscular hypertonicity and deviant body posture on the one hand and voice handicap and voice quality on the other hand in teachers with persistent voice complaints and a history of voice-related absenteeism. The study group consisted of 25 female teachers. A voice therapist assessed extrinsic laryngeal muscular tension and a physical therapist assessed body posture. The assessed parameters were clustered in categories. The parameters in the different categories represent the same function. Further a tension/posture index was created, which is the summation of the different parameters. The different parameters and the index were related to the Voice Handicap Index (VHI) and the Dysphonia Severity Index (DSI). The scores of the VHI and the individual parameters differ significantly except for the posterior weight bearing and tension of the sternocleidomastoid muscle. There was also a significant difference between the individual parameters and the DSI, except for tension of the cricothyroid muscle and posterior weight bearing. The score of the tension/posture index correlates significantly with both the VHI and the DSI. In a linear regression analysis, the combination of hypertonicity of the sternocleidomastoid, the geniohyoid muscles and posterior weight bearing is the most important predictor for a high voice handicap. The combination of hypertonicity of the geniohyoid muscle, posterior weight bearing, high position of the hyoid bone, hypertonicity of the cricothyroid muscle and anteroposition of the head is the most important predictor for a low DSI score. The results of this study show the higher the score of the index, the higher the score of the voice handicap and the worse the voice quality is. Moreover, the results are indicative for the importance of assessment of muscular tension and body posture in the diagnosis of voice disorders.
Asunto(s)
Evaluación de la Discapacidad , Contracción Muscular , Hipertonía Muscular/diagnóstico , Enfermedades Profesionales/diagnóstico , Postura , Enseñanza , Trastornos de la Voz/diagnóstico , Calidad de la Voz , Adulto , Femenino , Humanos , Músculos Laríngeos/fisiopatología , Contracción Muscular/fisiología , Hipertonía Muscular/fisiopatología , Músculos del Cuello/fisiopatología , Enfermedades Profesionales/etiología , Enfermedades Profesionales/fisiopatología , Postura/fisiología , Valores de Referencia , Trastornos de la Voz/etiología , Trastornos de la Voz/fisiopatología , Calidad de la Voz/fisiologíaRESUMEN
In 76 teachers with persisting voice problems, the maintaining factors and coping strategies were examined. Physical, functional, psychological and socioeconomic factors were assessed. A parallel was drawn to a psychological cascade model designed for patients with chronic back pain. The majority of the patients were found to be in a deadlocked situation (phase 1 of the cascade model), for which the combination of externalization and unawareness of the situation is the main risk factor. Subjective rating of the voice problem was assessed by the Voice Handicap Index (VHI) and a visual analogue scale (VAS). Patients in phase 1 of the cascade model showed higher VHI and VAS scores compared with the other patients. For a high VHI score, the combination of socioeconomic factors and being in phase 1 was the most important risk factor. Socioeconomic factors were the most important risk factors for a high VAS score. We introduce the term 'chronicity', which means that the problems are maintained, the patient finds himself in a deadlocked situation, and is sliding down into a chronic disease. 'Chronicity' is essentially different from 'chronic', which refers only to the duration of the disease. We consider maintaining factors and (inadequate) coping factors, which consist of emotional/psychological, physical and socioeconomic aspects, as indicators for chronicity.
Asunto(s)
Dolor de Espalda/psicología , Enseñanza , Trastornos de la Voz/etiología , Adaptación Psicológica , Adulto , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Trastornos de la Voz/diagnóstico , Trastornos de la Voz/terapia , Calidad de la VozRESUMEN
Laryngeal framework surgery, developed by Isshiki in the 1970s, is one of the most dynamic areas of phonosurgery and these procedures have served to considerably widen our spectrum and options for surgical improvement and/or changing of voice. As these techniques became more accepted and became common throughout the world, several new surgical modifications and different terms have been introduced. These new developments have lead to a confusion regarding terminology and types which make it difficult to communicate between and to compare the results of different authors. In an effort to create a more precise and descriptive list of definitions and terms, the Phonosurgery Committee of the European Laryngological Society has developed a new terminology for laryngeal framework surgery. In accordance with the concept of Isshiki, four types can be separated according to the intended purpose of the surgery: -Approximation laryngoplasty: medialization thyroplasty, arytenoid adduction. -Expansion laryngoplasty: lateralization thyroplasty, vocal fold abduction. -Relaxation laryngoplasty: shortening thyroplasty -Tensioning laryngoplasty: cricothyroid approximation, elongation thyroplasty. The proposed terms are functionally oriented and related closely to the intended purpose of the procedure or related to the underlying pathogenesis of the dysphonia. This new classification should provide a general framework suited not only to classify the current techniques but also to easily apply and adapt to include new procedures and future developments as necessary.
Asunto(s)
Enfermedades de la Laringe/cirugía , Otolaringología , Procedimientos Quirúrgicos Otorrinolaringológicos/clasificación , Terminología como Asunto , Humanos , Procedimientos Quirúrgicos Otorrinolaringológicos/métodos , Glándula Tiroides/cirugíaRESUMEN
By means of serial sectioning of the head and neck a paired, rod shaped, parachoanic lymphoid organ was identified in Lewis rats. Histological, ultrastructural studies and FACS analysis showed this organ to be a lympho-epithelial organ with high endothelial venules (HEV) and a preponderance of B over T and T helper over T suppressor cells. Consequently this organ resembles the pharyngeal tonsil of man, and it is called the Waldeyer ring equivalent (WRE). The lymphatic drainage of this organ occurs predominantly to the deep, and to a lesser extent to the superficial cervical lymph nodes. Migration studies with 51Cr labeled cells show that the WRE lymphoid cells migrate into the lymphoid organs with HEV (peripheral lymph nodes. Peyer patches and WRE). In this respect they resemble peripheral lymph node cells more than cells from the Peyer patches. Thus the WRE lymphoid tissue in the rat is undoubtedly involved in local oronasopharyngeal immune surveillance and may also contribute to mucosal and systemic immune responses.
Asunto(s)
Linfocitos/fisiología , Tejido Linfoide/citología , Tonsila Palatina/inmunología , Ratas Endogámicas Lew/anatomía & histología , Animales , Movimiento Celular/fisiología , Separación Celular , Citometría de Flujo , Ganglios Linfáticos/inmunología , Sistema Linfático/inmunología , Sistema Linfático/ultraestructura , Tejido Linfoide/inmunología , Masculino , Modelos Biológicos , Tonsila Palatina/ultraestructura , Ganglios Linfáticos Agregados/inmunología , Ratas , Ratas Endogámicas Lew/inmunologíaRESUMEN
Measurement of the middle ear muscle reflex is an important tool in audiologic examination; however, the precise function of the tensor tympani and stapedius muscle is not fully understood. The function of the middle ear muscles in speech discrimination and noise-induced hearing loss is the main object of our study. Morphologic and enzyme-histochemical properties of the middle ear muscles of the rat indicate a complex, fine-tuned function of the middle ear muscles. Both middle ear muscles are merely composed of relatively small fast-twitch fibers. Almost all fibers possess an enzymatic profile that allows aerobic as well as anaerobic metabolism. The innervation of the muscles is extensive, and motor end plates are well developed. In a parallel study, middle ear muscle contraction (to be analyzed by electromyography) will be correlated with a change of the sound transmission characteristics of the middle ear (measured by the electrocochlear and brainstem auditory evoked responses). Preliminary results of the electrophysiologic measurements (electrocochleogram and brainstem auditory evoked response) are presented.