Cases reported "Voice Disorders"

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1/132. Effects of systematized vocal warm-up on voices with disorders of various etiologies.

    This investigation studied the effect of a systematized vocal warm-up procedure on voices with disorders. There were 4 subjects with voice disorders. To optimize vocal function a systematized vocal warm-up system was developed by the author for singers and nonsingers alike. Subjects were asked to practice the vocal warm-up exercises daily, with weekly monitoring in the studio. Data from independent raters and subjects' self-ratings were compared to and corroborated with computer analysis of audio samples. Results indicated significant improvement in subjects' voices that were increasingly maintained over time.
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keywords = voice
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2/132. Goitre presenting as an oropharyngeal mass: an unusual finding in the elderly.

    Thyroid goitre presentation in the neck with extension inferiorly to the mediastinum is well-known. Extension superiorly into the retropharyngeal space is very rare and may be accompanied by change in voice and/or airway compromise. A case is described of a patient with change in voice and mild airway compromise secondary to a goitre presenting in the oropharynx. Computed tomography (CT) and physical findings are discussed with the need to recognize this rare entity.
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ranking = 0.28571428571429
keywords = voice
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3/132. Botox for hyperadduction of the false vocal folds: a case report.

    We present a patient with severe hyperadduction of the false vocal folds (FVF) treated with Botulinum Toxin injections to each FVF. This patient presented with severe dysphonia and was found to demonstrate severe hyperadduction of the FVF's with all phonatory tasks. The patient was treated with extensive speech therapy without improvement in voice quality nor FVF motion pattern. He was then injected with Botox A bilaterally using a peroral approach to the FVFs. Shortly after treatment the patient experienced dramatic improvement in voice quality. Videolaryngoscopy revealed no adduction of the FVFs with phonation and essentially normal true vocal fold motion. He remained with normal voice quality one year after treatment without any further treatment. Possible mechanism of action of this type of treatment are discussed.
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ranking = 0.42857142857143
keywords = voice
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4/132. The effects of excessive vocalization on acoustic and videostroboscopic measures of vocal fold condition.

    Although dysphonia is a recognized consequence of acute vocal abuse, associated changes in vocal fold appearance and function are not well understood. To document these presumed effects of vocal abuse, audio recordings of sustained vowel production were obtained from 42 drill sergeants daily during the first 6 days of a vocally demanding training exercise. Acoustic analysis showed abnormal levels of jitter and shimmer on Day 1 in 16 of the 42 subjects. Considering only the 26 subjects who showed normal voice acoustics on Day 1, the median levels of jitter and shimmer varied little over the course of training, and significant increases in jitter and shimmer were not seen during the study period. However, the distributions for both jitter and shimmer became more positively skewed and showed a greater number of positive outliers over the course of training. This trend was attributed to 11 subjects who showed two or more instances of abnormal voice acoustics over Days 2 through 6. Laryngeal videostroboscopic recordings of sustained vowel production also were obtained prior to and following training. Perceptual ratings of these recordings by 2 observers revealed significant increases in vocal fold edema, erythema, and edge irregularity, and decreases in vocal fold mucosal wave and amplitude of excursion following the 5-day training period. In general, there was considerable intersubject variability in the extent of acoustic and videostroboscopic effects over the course of training. Of the two types of data, videostroboscopy appears to provide a more sensitive indication of the effects of excessive vocalization.
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ranking = 0.28571428571429
keywords = voice
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5/132. Treatment of Parkinson hypophonia with percutaneous collagen augmentation.

    OBJECTIVES: It has been estimated that more than 70% of patients with parkinson disease experience voice and speech disorders characterized by weak and breathy phonation, and dysarthria. This study reports on the efficacy of treating Parkinson patients who have glottal insufficiency. STUDY DESIGN AND methods: Thirty-five patients underwent collagen augmentation of the vocal folds for hypophonia associated with parkinson disease, using a new technique of percutaneous injection with fiberoptic guidance. Patient response to the collagen augmentation was determined by telephone survey. RESULTS AND CONCLUSIONS: The procedure required minimal patient participation and was safely performed on all the patients who were studied. Results of the survey indicated that 75% of patient responses demonstrated satisfaction with the technique, compared with 16% of patient ratings reflecting dissatisfaction. These results were moderately correlated with the duration of improvement of the dysphonia. Results of this preliminary evaluation demonstrate that voice deficits in parkinson disease are amenable to vocal fold augmentation. Because this procedure requires minimal patient participation and can be safely performed in an office setting, it may also be useful in other severely debilitating neuromotor diseases that result in glottal insufficiency and hypophonia.
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ranking = 0.28571428571429
keywords = voice
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6/132. technology in the treatment of voice disorders.

    Currently there are several instruments that provide technological support for the treatment of patients with voice disorders. In this article, specific disorders are discussed along with the technologies that can be utilized to augment treatment. Not all forms of voice disorder can be covered, but representative samples from the major categories should provide sufficient information to encourage generalization to types that are not discussed.
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ranking = 0.85714285714286
keywords = voice
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7/132. A deaf woman learning to control her excessive vocal loudness through a portable feedback system.

    A deaf woman learned to control her excessive vocal loudness through a portable feedback system, which provided vibratory stimulation when her voice was too loud. The mean percentage of excessively loud talking decreased from 45 prior to the use of feedback to 3 during the use of feedback. This improvement (documented by formal observation) was confirmed by normally hearing people sharing the work environment with the woman. The woman preferred a system with a contact microphone since this was virtually unaffected by environmental noise.
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ranking = 0.14285714285714
keywords = voice
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8/132. Tracheo-oesophageal puncture by retrograde passage of a gastroscope via mini-laparotomy and gastrotomy.

    Secondary tracheo-oesophageal puncture is frequently used for voice restoration after laryngectomy. A method utilizing a flexible gastroscope passed via a mini-laparotomy and gastrotomy in a retrograde manner is described in a patient where extensive pharyngeal resection made it impossible to cannulate the upper aerodigestive tract. The patient suffered minimal morbidity and produced reasonable speech.
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ranking = 0.14285714285714
keywords = voice
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9/132. A report on alterations to the speaking and singing voices of four women following hormonal therapy with virilizing agents.

    Four women aged between 27 and 58 years sought otolaryngological examination due to significant alterations to their voices, the primary concerns being hoarseness in vocal quality, lowering of habitual pitch, difficulty projecting their speaking voices, and loss of control over their singing voices. Otolaryngological examination with a mirror or flexible laryngoscope revealed no apparent abnormality of vocal fold structure or function, and the women were referred for speech pathology with diagnoses of functional dysphonia. Objective acoustic measures using the Kay Visipitch indicated significant lowering of the mean fundamental frequency for each woman, and perceptual analysis of the patients' voices during quiet speaking, projected voice use, and comprehensive singing activities revealed a constellation of features typically noted in the pubescent male. The original diagnoses of a functional dysphonia were queried, prompting further exploration of each woman's medical history, revealing in each case onset of vocal symptoms shortly after commencing treatment for conditions with medications containing virilizing agents (eg, Danocrine (danazol), Deca-Durabolin (nandrolene decanoate), and testosterone). Although some of the vocal symptoms decreased in severity with the influences from 6 months voice therapy and after withdrawal from the drugs, a number of symptoms remained permanent, suggesting each subject had suffered significant alterations in vocal physiology, including muscle tissue changes, muscle coordination dysfunction, and propioceptive dysfunction. This retrospective study is presented in order to illustrate that it was both the projected speaking voice and the singing voice that proved so highly sensitive to the virilization effects. The implications for future prospective research studies and responsible clinical practice are discussed.
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ranking = 1.7142857142857
keywords = voice
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10/132. Midline lateralization thyroplasty for adductor spasmodic dysphonia.

    Midline lateralization thyroplasty was successfully performed on a patient with adductor spasmodic dysphonia. The thyroid cartilage was incised at the midline, and a 3 x 2-mm perforation was made at the anterior commissure to widen it. The perforation was closed with a free composite graft taken from the upper edge of the thyroid ala, and the incised thyroid cartilage edges were kept separated 4 mm apart with silicone wedges. A part of the sternohyoid muscle was rotated to seal any leak from the perforation. The postoperative course was uneventful. The voice has been restored to normal, and there is no sign of recurrence of the symptom so far, as of 1 year 5 months postoperative. Although a longer follow-up is needed, this case indicates that midline type II thyroplasty could be a useful treatment for adductor spasmodic dysphonia.
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ranking = 0.14285714285714
keywords = voice
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