The mechanism of vocal cord motion while stuttering remains unclear. A study by Conture et al. (1977) presented 100 % glottic closures with only a sample of six stuttering blocks. A larger study sample was required. This study examined 34 stuttering blocks through flexible fiberscopic imaging and mesurements by speech phonogram, airflows and voice waveforms. The percentage of glottic closure and glottic opening were about 50 % and 50 % respectively. Vocal cord positions varied from individual to individual while block were manifested. Our findings indicate the cause of stuttering in not to be larynx but rather in the brain.
{"title":"Vocal Cord Motion during Stutter Blocks","authors":"Y. Kikuchi, T. Umezaki, K. Adachi, S. Komune","doi":"10.5426/LARYNX.25.79","DOIUrl":"https://doi.org/10.5426/LARYNX.25.79","url":null,"abstract":"The mechanism of vocal cord motion while stuttering remains unclear. A study by Conture et al. (1977) presented 100 % glottic closures with only a sample of six stuttering blocks. A larger study sample was required. This study examined 34 stuttering blocks through flexible fiberscopic imaging and mesurements by speech phonogram, airflows and voice waveforms. The percentage of glottic closure and glottic opening were about 50 % and 50 % respectively. Vocal cord positions varied from individual to individual while block were manifested. Our findings indicate the cause of stuttering in not to be larynx but rather in the brain.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131013876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Electrophysiologic Research of Larynx","authors":"S. Chitose","doi":"10.5426/LARYNX.25.43","DOIUrl":"https://doi.org/10.5426/LARYNX.25.43","url":null,"abstract":"","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126320998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The treatment of laryngotracheal stenosis remains a challenge. Our previous studies focused on basic research and the clinical applications of an artificial trachea. In this study we focused on the challenge posed by the fact that a prefabricated artificial trachea cannot be utilized for pediatric airways since the tracheal frame needs to expand as the child develops. Induced pluripotent stem(iPS)cells were first generated in 2006. These cells are capable of unlimited symmetrical self-renewal, thus providing an unlimited cell source for tissue-engineering applications. In this report, iPS cells were cultured in a three-dimensional(3 D)scaffold in Chondrocyte Differentiation Medium (CDM). After cultivation, differentiation into chondrocytes was examined. The ratio of undifferentiated cells was analyzed by flow cytometry. The 3D scaffolds were implanted into tracheal defects in 24 nude rats. Differentiation into chondrocytes in vitro was confirmed histologically, phenotypically and genetically. Flow cytometric analysis demonstrated that the population of undifferentiated cells had decreased. Cartilage tissue was observed in the regenerated tracheal wall. The expression of cartilage-specific protein was also demonstrated in vivo. The presence of the green fluorescent protein(GFP)gene derived from iPS cells was confirmed in samples of cartilage tissue by the combination of Laser Microdissection(LMD)and Polymerase Chain Reaction(PCR)techniches. Our results suggest that iPS cells could be a new cell source for the regeneration of the trachea.
{"title":"Induced Pluripotent Stem (iPS) Cells for the Regeneration of Trachea and Larynx","authors":"Mitsuyoshi Imaizumi, K. Omori","doi":"10.5426/LARYNX.25.30","DOIUrl":"https://doi.org/10.5426/LARYNX.25.30","url":null,"abstract":"The treatment of laryngotracheal stenosis remains a challenge. Our previous studies focused on basic research and the clinical applications of an artificial trachea. In this study we focused on the challenge posed by the fact that a prefabricated artificial trachea cannot be utilized for pediatric airways since the tracheal frame needs to expand as the child develops. Induced pluripotent stem(iPS)cells were first generated in 2006. These cells are capable of unlimited symmetrical self-renewal, thus providing an unlimited cell source for tissue-engineering applications. In this report, iPS cells were cultured in a three-dimensional(3 D)scaffold in Chondrocyte Differentiation Medium (CDM). After cultivation, differentiation into chondrocytes was examined. The ratio of undifferentiated cells was analyzed by flow cytometry. The 3D scaffolds were implanted into tracheal defects in 24 nude rats. Differentiation into chondrocytes in vitro was confirmed histologically, phenotypically and genetically. Flow cytometric analysis demonstrated that the population of undifferentiated cells had decreased. Cartilage tissue was observed in the regenerated tracheal wall. The expression of cartilage-specific protein was also demonstrated in vivo. The presence of the green fluorescent protein(GFP)gene derived from iPS cells was confirmed in samples of cartilage tissue by the combination of Laser Microdissection(LMD)and Polymerase Chain Reaction(PCR)techniches. Our results suggest that iPS cells could be a new cell source for the regeneration of the trachea.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127612915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Transoral Laser Microsurgery for Early and Moderately Advanced Laryngeal Cancer","authors":"P. Chu","doi":"10.5426/LARYNX.25.27","DOIUrl":"https://doi.org/10.5426/LARYNX.25.27","url":null,"abstract":"","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130288962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Laryngeal Research in Vanderbilt University","authors":"A. Suehiro","doi":"10.5426/LARYNX.25.49","DOIUrl":"https://doi.org/10.5426/LARYNX.25.49","url":null,"abstract":"","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"422 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126713801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Murata, Tetsuaki Shimada, M. Shino, Y. Yasuoka, K. Chikamatsu
Conventional arytenoid adduction is often associated with a risk of perforating the piriform sinus, bleeding or edema of the larynx following airway obstruction. We designed a simple and less invasive method, Endoscopicassisted Arytenoid Adduction Surgery (EAAS), for unilateral vocal fold paralysis (UVFP), in which we employ a looped traction nylon thread under laryngeal endoscopic guidance. We reported that our phonation analysis date thus far has indicated the efficacy of EAAS and that no major complications such as airway obstruction have occurred. As it is truly important to evaluate how patients personally perceive their benefits, we now evaluate them using an objective index such as Japanese versions of voice handicap index (VHI) and singing voice handicap index (SVHI). We retrospectively examined 14 patients with UVFP for the following measurements: maximum phonation time (MPT), mean air flow rate (MFR), and three acoustic analysis parameters which were measured before and after EAAS. Ten of them answered the VHI and SVHI questionnaires. Postoperatively, VHI score significantly improved from their preoperative values, but SVHI have not done so. Statistical correlations were seen between VHI and MPT or MFR. These results suggest the validity of EAAS from the perspective of the voice handicap of phonation disorder.
{"title":"The Impact of Endoscopic-Assisted Arytenoid Adduction Surgery on Phonation Disorder Voice Handicap","authors":"T. Murata, Tetsuaki Shimada, M. Shino, Y. Yasuoka, K. Chikamatsu","doi":"10.5426/LARYNX.25.83","DOIUrl":"https://doi.org/10.5426/LARYNX.25.83","url":null,"abstract":"Conventional arytenoid adduction is often associated with a risk of perforating the piriform sinus, bleeding or edema of the larynx following airway obstruction. We designed a simple and less invasive method, Endoscopicassisted Arytenoid Adduction Surgery (EAAS), for unilateral vocal fold paralysis (UVFP), in which we employ a looped traction nylon thread under laryngeal endoscopic guidance. We reported that our phonation analysis date thus far has indicated the efficacy of EAAS and that no major complications such as airway obstruction have occurred. As it is truly important to evaluate how patients personally perceive their benefits, we now evaluate them using an objective index such as Japanese versions of voice handicap index (VHI) and singing voice handicap index (SVHI). We retrospectively examined 14 patients with UVFP for the following measurements: maximum phonation time (MPT), mean air flow rate (MFR), and three acoustic analysis parameters which were measured before and after EAAS. Ten of them answered the VHI and SVHI questionnaires. Postoperatively, VHI score significantly improved from their preoperative values, but SVHI have not done so. Statistical correlations were seen between VHI and MPT or MFR. These results suggest the validity of EAAS from the perspective of the voice handicap of phonation disorder.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128469745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Spasmodic dysphonia （SD） is a focal dystonia that affects the larynx. Abductor SD （ABSD） is less common than adductor SD （ADSD）. ABSD is typified by breathy breaks in connected speech. A male professional classic baritone singer, age 46, presented with gradually increasing breathy unphonated breaks in singing over the course of three years. He visited various institutions and was said to have incom-plete elevation of the soft palate of unknown origin, myasthenia gravis, etc. His symptoms were remarkable in pronouncing vowels following unphonated consonants. He had been exposed to neither vocal abuse nor heavy singing performances. Our diagnosis was ABSD. An injection of Botulinum toxin （BT） into the posterior cricoarytenoid muscles was done via lateral cervical approach. His voice improved remarkably. His daily conver-sation became smooth; however, he could not regain his previous brilliant singing voice. He was obliged to dis-continue his professional singing performances.
{"title":"Abductor Spasmodic Dysphonia Found in a Singer","authors":"Takeo Kobayashi, Miyoko Ishige, Atsushi Ichinose","doi":"10.5426/LARYNX.25.12","DOIUrl":"https://doi.org/10.5426/LARYNX.25.12","url":null,"abstract":"Spasmodic dysphonia （SD） is a focal dystonia that affects the larynx. Abductor SD （ABSD） is less common than adductor SD （ADSD）. ABSD is typified by breathy breaks in connected speech. A male professional classic baritone singer, age 46, presented with gradually increasing breathy unphonated breaks in singing over the course of three years. He visited various institutions and was said to have incom-plete elevation of the soft palate of unknown origin, myasthenia gravis, etc. His symptoms were remarkable in pronouncing vowels following unphonated consonants. He had been exposed to neither vocal abuse nor heavy singing performances. Our diagnosis was ABSD. An injection of Botulinum toxin （BT） into the posterior cricoarytenoid muscles was done via lateral cervical approach. His voice improved remarkably. His daily conver-sation became smooth; however, he could not regain his previous brilliant singing voice. He was obliged to dis-continue his professional singing performances.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128364855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Naito, Tomoaki Murashima, Tatsuyoshi Okada, Hisayuki Kato, Kazuo Sakurai
In recent years, the occurrence of chronic cough patients with accompanying allergic factor has increased. The main causes of these patients’ symptoms are laryngeal allergy, atopic cough, cough variant asthma and clas-sic bronchial asthma. We observed a case of chronic cough of unknown cause that was initially suspected to be the result of laryngeal allergy. A forty-seven-year-old female complaining of a persistent dry cough for seven months visited our clinic. She had Japanese cedar hay fever with a higher level of serum specific IgE to cedar pollen. No abnormal findings were found in CT and X-ray imaging of her chest. Peroral ingestion of H1 blocker, bronchodilator, proton pump inhibitor, antibiotics, minor tranquilizer and cough remedy were entirely ineffective and the patient was diagnosed as having a cough of unknown cause. Peroral ingestion of Bakumondoto （Mai Men Dong Tang）, a Chinese blended medicine and 1% codeine phosphate hydrate powder showed tremendous effectiveness. The combined treatment of the two medicines was found to be an effective therapy for such case of chronic cough of unknown cause.
{"title":"A Case Report-Unknown Cause of Chronic Cough Suspected to be Laryngeal Allergy","authors":"K. Naito, Tomoaki Murashima, Tatsuyoshi Okada, Hisayuki Kato, Kazuo Sakurai","doi":"10.5426/LARYNX.25.15","DOIUrl":"https://doi.org/10.5426/LARYNX.25.15","url":null,"abstract":"In recent years, the occurrence of chronic cough patients with accompanying allergic factor has increased. The main causes of these patients’ symptoms are laryngeal allergy, atopic cough, cough variant asthma and clas-sic bronchial asthma. We observed a case of chronic cough of unknown cause that was initially suspected to be the result of laryngeal allergy. A forty-seven-year-old female complaining of a persistent dry cough for seven months visited our clinic. She had Japanese cedar hay fever with a higher level of serum specific IgE to cedar pollen. No abnormal findings were found in CT and X-ray imaging of her chest. Peroral ingestion of H1 blocker, bronchodilator, proton pump inhibitor, antibiotics, minor tranquilizer and cough remedy were entirely ineffective and the patient was diagnosed as having a cough of unknown cause. Peroral ingestion of Bakumondoto （Mai Men Dong Tang）, a Chinese blended medicine and 1% codeine phosphate hydrate powder showed tremendous effectiveness. The combined treatment of the two medicines was found to be an effective therapy for such case of chronic cough of unknown cause.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126293730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The causes of age-related hoarseness include 1) a decreased amount of mucus covering the vocal cord surface; 2) a decreased content of hyaluronic acid in the superficial layer of the vocal cord lamina propria ; and 3) age-related atrophy of the vocal cord. Patients with presbyphonia resulting from the second or third causes listed above often show evidence of vocal cord atrophy, such as imperfect closure of the glottis and reduced duration of glottal closure. Some of the middle-aged and older patients with little evidence of vocal cord atrophy have relevant endoscopic findings and/or subjective symptoms, such as sputum sticking sensation during speech and dry mouth. Saliva keeps the vocal cord mucosa moist and serves as a lubricant during speech. Only a limited number of studies have examined the relationship between reduced moisture content of the vocal cord mucosa associated with hyposalivation and the development of presbyphonia. The objective of this study was to evaluate the effectiveness of sialagogue pilocarpine hydrochloride in improving vocal function in patients with vocal disorders considered to be caused by reduced moisture content of the vocal cord mucosa due to hyposalivation. This study included 20 patients aged 60 years and up who were complaining of hoarseness suspected to be the result of reduced secretion of laryngeal mucus and who displayed no apparent space-occupying lesion or vocal cord atrophy. Pilocarpine hydrochloride administered via tablets 1-3 times daily for 4 weeks resulted in increased saliva secretion as well as significant improvement in VHI and acoustic parameters. The results demonstrate the efficacy of pilocarpine hydrochloride for promoting saliva secretion in the treatment of presbyphonia.
{"title":"The Effect of The Pilocarpine on Voice-disorder due to Salivation Functional Decline in The Elderly","authors":"Fumimasa Toyomura, R. Tokashiki, Hiroyuki Hiramatsu, Eriko Sakurai, Masaki Nomoto, Mamoru Suzuki","doi":"10.5426/LARYNX.25.8","DOIUrl":"https://doi.org/10.5426/LARYNX.25.8","url":null,"abstract":"The causes of age-related hoarseness include 1) a decreased amount of mucus covering the vocal cord surface; 2) a decreased content of hyaluronic acid in the superficial layer of the vocal cord lamina propria ; and 3) age-related atrophy of the vocal cord. Patients with presbyphonia resulting from the second or third causes listed above often show evidence of vocal cord atrophy, such as imperfect closure of the glottis and reduced duration of glottal closure. Some of the middle-aged and older patients with little evidence of vocal cord atrophy have relevant endoscopic findings and/or subjective symptoms, such as sputum sticking sensation during speech and dry mouth. Saliva keeps the vocal cord mucosa moist and serves as a lubricant during speech. Only a limited number of studies have examined the relationship between reduced moisture content of the vocal cord mucosa associated with hyposalivation and the development of presbyphonia. The objective of this study was to evaluate the effectiveness of sialagogue pilocarpine hydrochloride in improving vocal function in patients with vocal disorders considered to be caused by reduced moisture content of the vocal cord mucosa due to hyposalivation. This study included 20 patients aged 60 years and up who were complaining of hoarseness suspected to be the result of reduced secretion of laryngeal mucus and who displayed no apparent space-occupying lesion or vocal cord atrophy. Pilocarpine hydrochloride administered via tablets 1-3 times daily for 4 weeks resulted in increased saliva secretion as well as significant improvement in VHI and acoustic parameters. The results demonstrate the efficacy of pilocarpine hydrochloride for promoting saliva secretion in the treatment of presbyphonia.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"133 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114887249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Sueyoshi, H. Umeno, S. Chitose, T. Kurita, T. Ono, A. Maeda, T. Nakashima
We retrospectively reviewed 27 patients with laryngeal granulomas who were surgically treated at the Kurume University Hospital between November 1990 and January 2011. There were 17 men and 10 women whose ages ranged from 23 to 75 years （median : 52.5 years）. The chief symptoms were hoarseness in 20 cases （74.1%）, dyspnea in 9 （33.3%）, pharynx incongruity in 4 （14.8%） and cough in 1（3.7%）. Causes of the disease were intubation in 13 cases （48 . 1 %）, voice abuse in 3 （11 . 1 %）, gastro-esophageal reflux disease in 2 （7.4%）, cough and injury in one, respectively. While the posterior glottis was the most frequent site of granuloma development, as found in 20 cases （74.1%）, there were a few cases of development in the membranous po-tions of the anterior commissure and subglottis. With regard to the size of the granulomas, 10 to 14mm was the most frequent occurrence, thereby indicating surgery. Post operative recurrence was observed in 12 cases （44.4%）, but they recovered by conservative treatment in most cases. In the analysis of recurrence according to the cause of granulomas, a “temporary stimulus” such as intubation and injury revealed lower rate than cases where granuloma were caused by a “repetitive stimulus” such as vocal abuse, reflux of stomach acid and cough （p=0.05）. had a lower rate of recurrence than excision with CO 2 laser. Steroid injection into the wound after excision showed a lower rate of recurrence in granulomas by temporary stimulus, and showed a significantly lower rate than CO 2 laser vaporization to the wound （p=0.01）.
{"title":"Clinical Post-Operative Observation of 27 Laryngeal Granuloma Cases","authors":"S. Sueyoshi, H. Umeno, S. Chitose, T. Kurita, T. Ono, A. Maeda, T. Nakashima","doi":"10.5426/LARYNX.25.1","DOIUrl":"https://doi.org/10.5426/LARYNX.25.1","url":null,"abstract":"We retrospectively reviewed 27 patients with laryngeal granulomas who were surgically treated at the Kurume University Hospital between November 1990 and January 2011. There were 17 men and 10 women whose ages ranged from 23 to 75 years （median : 52.5 years）. The chief symptoms were hoarseness in 20 cases （74.1%）, dyspnea in 9 （33.3%）, pharynx incongruity in 4 （14.8%） and cough in 1（3.7%）. Causes of the disease were intubation in 13 cases （48 . 1 %）, voice abuse in 3 （11 . 1 %）, gastro-esophageal reflux disease in 2 （7.4%）, cough and injury in one, respectively. While the posterior glottis was the most frequent site of granuloma development, as found in 20 cases （74.1%）, there were a few cases of development in the membranous po-tions of the anterior commissure and subglottis. With regard to the size of the granulomas, 10 to 14mm was the most frequent occurrence, thereby indicating surgery. Post operative recurrence was observed in 12 cases （44.4%）, but they recovered by conservative treatment in most cases. In the analysis of recurrence according to the cause of granulomas, a “temporary stimulus” such as intubation and injury revealed lower rate than cases where granuloma were caused by a “repetitive stimulus” such as vocal abuse, reflux of stomach acid and cough （p=0.05）. had a lower rate of recurrence than excision with CO 2 laser. Steroid injection into the wound after excision showed a lower rate of recurrence in granulomas by temporary stimulus, and showed a significantly lower rate than CO 2 laser vaporization to the wound （p=0.01）.","PeriodicalId":126820,"journal":{"name":"THE LARYNX JAPAN","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123601086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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