Caustic ingestions are rare, life-threatening injuries with life-long consequences. Injury can occur anywhere from the lips to stomach but tends to be most severe in the esophagus. Aspiration of caustic substances can lead to laryngeal or tracheobronchial injury and airway compromise. Caustic injuries come in two main varieties: acidic and alkaline-induced injuries. The type and state of agent determines in part the location of injury and depth of injury. Management consists of comprehensive evaluation and stabilization and must consider airway safety. Endoscopic evaluation and staging of the esophagus should be done within 24 hours of ingestion but not before 6 hours. Nasogastric tube placement should be considered based on the stage of the injury. Antibiotics, acid-suppressants, and corticosteroids may have a roll for certain patients but must be determined on an individual basis. Long-term follow up is required to monitor for strictures and patients with caustic esophageal injury are at increased risk of esophageal carcinoma. This review will help both junior and senior Otolaryngology residents recognize, evaluate and manage causing ingestions in pediatric patients. This review contains figures, tables, and references Keywords: Caustic ingestion, acid, alkali, endoscopic grading, strictures, mitomycin C, balloon dilatation
{"title":"Caustic Ingestion","authors":"Luis D. Vilchez-Madrigal, G. Jiménez, N. Wolter","doi":"10.2310/ot.7077","DOIUrl":"https://doi.org/10.2310/ot.7077","url":null,"abstract":"Caustic ingestions are rare, life-threatening injuries with life-long consequences. Injury can occur anywhere from the lips to stomach but tends to be most severe in the esophagus. Aspiration of caustic substances can lead to laryngeal or tracheobronchial injury and airway compromise. Caustic injuries come in two main varieties: acidic and alkaline-induced injuries. The type and state of agent determines in part the location of injury and depth of injury. Management consists of comprehensive evaluation and stabilization and must consider airway safety. Endoscopic evaluation and staging of the esophagus should be done within 24 hours of ingestion but not before 6 hours. Nasogastric tube placement should be considered based on the stage of the injury. Antibiotics, acid-suppressants, and corticosteroids may have a roll for certain patients but must be determined on an individual basis. Long-term follow up is required to monitor for strictures and patients with caustic esophageal injury are at increased risk of esophageal carcinoma. This review will help both junior and senior Otolaryngology residents recognize, evaluate and manage causing ingestions in pediatric patients.\u0000This review contains figures, tables, and references\u0000Keywords: Caustic ingestion, acid, alkali, endoscopic grading, strictures, mitomycin C, balloon dilatation","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126230346","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}
Laryngeal stenosis involving the glottis and subglottis is a commonly encountered and potentially life-threatening pathology in children. It is important to differentiate the key features of laryngeal anatomy and clinical presentation of laryngeal stenosis in children. Endotracheal tube related injuries are an important culprit in the pathophysiology of laryngeal stenosis, particularly when intubation is traumatic. Stenosis may also occur if the size of the tube is chosen inappropriately, or if repeated intubations are performed. In one’s assessment, critical points include appropriately sizing the airway and describing the site, length and consistency of the stenosis. An approach to management can then be chosen based on the specific elements of the laryngeal stenosis and other patient-related characteristics. This review contains 11 figures, 5 tables, and 36 references Keywords: subglottic, glottic, stenosis
{"title":"Subglottic and Glottic Stenosis","authors":"D. Sidell, T. Din","doi":"10.2310/ot.7075","DOIUrl":"https://doi.org/10.2310/ot.7075","url":null,"abstract":"Laryngeal stenosis involving the glottis and subglottis is a commonly encountered and potentially life-threatening pathology in children. It is important to differentiate the key features of laryngeal anatomy and clinical presentation of laryngeal stenosis in children. Endotracheal tube related injuries are an important culprit in the pathophysiology of laryngeal stenosis, particularly when intubation is traumatic. Stenosis may also occur if the size of the tube is chosen inappropriately, or if repeated intubations are performed. In one’s assessment, critical points include appropriately sizing the airway and describing the site, length and consistency of the stenosis. An approach to management can then be chosen based on the specific elements of the laryngeal stenosis and other patient-related characteristics.\u0000This review contains 11 figures, 5 tables, and 36 references\u0000Keywords: subglottic, glottic, stenosis","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"514 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116561735","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}
Brow lifting techniques have applications in periorbital facial rejuvenation, establishing improved symmetry, and addressing sequela of facial paralysis. An understanding of fascial planes, mimetic muscles, and neural anatomy guides safe surgical planning. Preoperative assessment should include a thorough history, physical exam with focus on the upper horizontal third of the face, and photo documentation. Selection of operative technique and potential fixation should be individualized to the patient. Botulinum toxin can be used to elevate the position of the brows. This review contains 13 figures, 4 tables, and 29 references Keywords: brow lift, upper facial anatomy, facial analysis, brow lift surgical technique, brow lift surgical approach, endoscopic brow lift
{"title":"Brow Lift","authors":"Caitlin M. Coviello, Sunthosh K. Sivam","doi":"10.2310/ot.7095","DOIUrl":"https://doi.org/10.2310/ot.7095","url":null,"abstract":"Brow lifting techniques have applications in periorbital facial rejuvenation, establishing improved symmetry, and addressing sequela of facial paralysis. An understanding of fascial planes, mimetic muscles, and neural anatomy guides safe surgical planning. Preoperative assessment should include a thorough history, physical exam with focus on the upper horizontal third of the face, and photo documentation. Selection of operative technique and potential fixation should be individualized to the patient. Botulinum toxin can be used to elevate the position of the brows.\u0000This review contains 13 figures, 4 tables, and 29 references\u0000Keywords: brow lift, upper facial anatomy, facial analysis, brow lift surgical technique, brow lift surgical approach, endoscopic brow lift","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132408940","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 nose is located within the central portion of the craniofacial skeleton and serves many important functions for human respiration and overall well-being. These functions include warming, humidifying and delivering air to the lower respiratory tract as well as conveyance of odorants to the olfactory epithelium and removal of particulate debris. In addition, the nose is physiologically dynamic with a rich neurovascular supply and hosts a variety of immunologic mediators. Several anatomic factors and disease states can affect these functions, therefore, a thorough understanding of the anatomy and physiology of the nose and nasal cavity are required for the evaluating otolaryngologist. This review contains 9 figures, 5 tables, and 43 references Keywords: Nasal function, nasal anatomy, nasal airflow, nasal resistance, nasal endoscopy
{"title":"Nasal Function and Evaluation","authors":"A. Jafari, I. Humphreys","doi":"10.2310/ot.7042","DOIUrl":"https://doi.org/10.2310/ot.7042","url":null,"abstract":"The nose is located within the central portion of the craniofacial skeleton and serves many important functions for human respiration and overall well-being. These functions include warming, humidifying and delivering air to the lower respiratory tract as well as conveyance of odorants to the olfactory epithelium and removal of particulate debris. In addition, the nose is physiologically dynamic with a rich neurovascular supply and hosts a variety of immunologic mediators. Several anatomic factors and disease states can affect these functions, therefore, a thorough understanding of the anatomy and physiology of the nose and nasal cavity are required for the evaluating otolaryngologist.\u0000\u0000This review contains 9 figures, 5 tables, and 43 references\u0000Keywords: Nasal function, nasal anatomy, nasal airflow, nasal resistance, nasal endoscopy","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129332407","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}
A comprehensive understanding of vestibular anatomy and physiology is essential to interpreting and treating vestibular disorders. The otolithic organs and semicircular canals are the major components of the vestibular system. Each contains hair cells, mechanosensory cells responsible for converting mechanical signals produced by the body into electrical signals. Each hair cell produces a resting discharge rate. This rate can be increased or decreased as a result of head motion, with the magnitude of change dependent on the direction and strength of the motion. These signals are sent to the vestibulocochlear nerve which interprets and integrates the information with input from other sensory organs. The main role of the vestibular system is to maintain balance and detect angular and linear acceleration. Angular acceleration is detected by the semicircular canal via interpretation of endolymph flow caused by head movement. Linear acceleration is detected by the otolith organs through gravity-dependent otoconia movement. This article serves as a review for the structure and function of the major vestibular organs. This review contains, 9 figures, 1 table, and 8 references Keywords: Vestibular physiology, Hair cells, Otolith organs, Macule, Semicircular canals, Ampulla, Crista, Vestibulocochlear nerve, Angular acceleration, Linear acceleration
{"title":"Anatomy and Physiology of Vestibular System","authors":"Gary Chi, Matthew G. Crowson","doi":"10.2310/ot.7027","DOIUrl":"https://doi.org/10.2310/ot.7027","url":null,"abstract":"A comprehensive understanding of vestibular anatomy and physiology is essential to interpreting and treating vestibular disorders. The otolithic organs and semicircular canals are the major components of the vestibular system. Each contains hair cells, mechanosensory cells responsible for converting mechanical signals produced by the body into electrical signals. Each hair cell produces a resting discharge rate. This rate can be increased or decreased as a result of head motion, with the magnitude of change dependent on the direction and strength of the motion. These signals are sent to the vestibulocochlear nerve which interprets and integrates the information with input from other sensory organs. The main role of the vestibular system is to maintain balance and detect angular and linear acceleration. Angular acceleration is detected by the semicircular canal via interpretation of endolymph flow caused by head movement. Linear acceleration is detected by the otolith organs through gravity-dependent otoconia movement. This article serves as a review for the structure and function of the major vestibular organs.\u0000\u0000This review contains, 9 figures, 1 table, and 8 references \u0000Keywords: Vestibular physiology, Hair cells, Otolith organs, Macule, Semicircular canals, Ampulla, Crista, Vestibulocochlear nerve, Angular acceleration, Linear acceleration","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121057395","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}
Benign laryngeal lesions represent a diverse set of pathologies whose clinical presentation may range from no symptoms to dyspnea and/or dysphonia. Flexible fiberoptic laryngoscopy and videolaryngostroboscopy are important in distinguishingdifferent types of lesions, and management and treatment are dependent on the identification of these lesions, as they have different etiologies. Some lesions such as vocal fold nodules and polyps are primarily phonotraumatic and may benefit fromspeech therapy and vocal hygiene as initial approaches. Vocal fold cysts and benign tumors may benefit from microlaryngeal approaches, while capillary ectasias, polypoid corditis, laryngoceles, saccular cysts, and papilloma may benefit from laser therapy. Vocal fold granulomas may arise from various etiologies such as intubation, traumatic behaviors, or reflux. Polypoid corditis arises from smoking. This review is intended to provide an overview of the variety of lesions that encompass non-malignant laryngeal lesions that is both suitable for junior and senior residents. This review contains 12 figures, 5 tables, and 64 references Keywords: Benign laryngeal lesions, Laryngocele, Polyp, Cyst, Polypoid Corditis, Papilloma
{"title":"Benign Laryngeal Lesions","authors":"Jeffrey Straub, Brandon Kim","doi":"10.2310/ot.7059","DOIUrl":"https://doi.org/10.2310/ot.7059","url":null,"abstract":"Benign laryngeal lesions represent a diverse set of pathologies whose clinical presentation may range from no symptoms to dyspnea and/or dysphonia. Flexible fiberoptic laryngoscopy and videolaryngostroboscopy are important in distinguishingdifferent types of lesions, and management and treatment are dependent on the identification of these lesions, as they have different etiologies. Some lesions such as vocal fold nodules and polyps are primarily phonotraumatic and may benefit fromspeech therapy and vocal hygiene as initial approaches. Vocal fold cysts and benign tumors may benefit from microlaryngeal approaches, while capillary ectasias, polypoid corditis, laryngoceles, saccular cysts, and papilloma may benefit from laser therapy. Vocal fold granulomas may arise from various etiologies such as intubation, traumatic behaviors, or reflux. Polypoid corditis arises from smoking. This review is intended to provide an overview of the variety of lesions that encompass non-malignant laryngeal lesions that is both suitable for junior and senior residents.\u0000\u0000This review contains 12 figures, 5 tables, and 64 references\u0000Keywords: Benign laryngeal lesions, Laryngocele, Polyp, Cyst, Polypoid Corditis, Papilloma","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115377263","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}
A mastery of facial and eyelid anatomy is paramount to perform oculoplastic surgery safely and successfully. An understanding of periocular structures, vasculature, and innervation highlights the delicate relationship between form and function, which establishes the foundation for cosmetic and reconstructive procedures. This knowledge, coupled with an appreciation for the patient’s goals – both functional and aesthetic – and expectations for the outcome of surgery allows one to complete an effective, multidimensional pre-operative assessment encompassing patient selection, history, physical examination, and ancillary testing. Ultimately, the synthesis of these principles guides the selection and execution of appropriate and efficacious surgical technique for blepharoplasty and eyelid reconstruction. This review contains 15 figures and 28 references Keywords: Eyelid anatomy, Eyelid crease, Eyelid margin, Canthal tendons, Lacrimal system, Blepharoplasty, Tenzel flap, Hughes flap, Cutler-Beard procedure, Canthotomy and cantholysis
{"title":"Blepharoplasty and Eyelid Reconstruction","authors":"A. Kamboj, A. Mokhtarzadeh","doi":"10.2310/ot.7094","DOIUrl":"https://doi.org/10.2310/ot.7094","url":null,"abstract":"A mastery of facial and eyelid anatomy is paramount to perform oculoplastic surgery safely and successfully. An understanding of periocular structures, vasculature, and innervation highlights the delicate relationship between form and function, which establishes the foundation for cosmetic and reconstructive procedures. This knowledge, coupled with an appreciation for the patient’s goals – both functional and aesthetic – and expectations for the outcome of surgery allows one to complete an effective, multidimensional pre-operative assessment encompassing patient selection, history, physical examination, and ancillary testing. Ultimately, the synthesis of these principles guides the selection and execution of appropriate and efficacious surgical technique for blepharoplasty and eyelid reconstruction.\u0000\u0000This review contains 15 figures and 28 references\u0000Keywords: Eyelid anatomy, Eyelid crease, Eyelid margin, Canthal tendons, Lacrimal system, Blepharoplasty, Tenzel flap, Hughes flap, Cutler-Beard procedure, Canthotomy and cantholysis","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116011693","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}
Anterior skull base surgery requires intimate knowledge of a highly complex anatomic region containing critical neurovascular structures. A wide array of pathologies can occur along the anterior cranial base, including meningiomas, esthesioneuroblastomas, pituitary adenomas, craniopharyngiomas, chondrosarcomas, and chordomas. Advancements in endoscopic sinus surgery have allowed many of these tumors to be effectively treated via an endoscopic endonasal technique. This approach obviates the need for large incisions causing cosmetic deformity, improves magnification of the surgical field, and offers a direct path to lesions thus avoiding retraction of structures such as the brain and nerves. Surgeons must understand the limitations of endoscopic techniques and consider open or combined open and endoscopic approaches when appropriate. Reconstructive anterior skull base techniques vary depending on the size and location of defects, along with factors such as intracranial pressure and patient co-morbidities. Large skull base defects require multilayer reconstruction that include a watertight primary dural repair with either synthetic or autologous tissue, followed by local vascularized tissue flaps. This review contains 8 figures, 2 videos, 4 tables and 33 references Key words: Anterior skull base, meningioma, esthesioneuroblastoma, chordoma, pituitary, CSF leak, nasosptal flap, dural repair, expanded endonasal approaches, endoscopic surgery
{"title":"Anterior Skull Base Tumors and Surgery","authors":"J. Fastenberg, Gurston Nyquist, Blair M Barton","doi":"10.2310/ot.7057","DOIUrl":"https://doi.org/10.2310/ot.7057","url":null,"abstract":"Anterior skull base surgery requires intimate knowledge of a highly complex anatomic region containing critical neurovascular structures. A wide array of pathologies can occur along the anterior cranial base, including meningiomas, esthesioneuroblastomas, pituitary adenomas, craniopharyngiomas, chondrosarcomas, and chordomas. Advancements in endoscopic sinus surgery have allowed many of these tumors to be effectively treated via an endoscopic endonasal technique. This approach obviates the need for large incisions causing cosmetic deformity, improves magnification of the surgical field, and offers a direct path to lesions thus avoiding retraction of structures such as the brain and nerves. Surgeons must understand the limitations of endoscopic techniques and consider open or combined open and endoscopic approaches when appropriate. Reconstructive anterior skull base techniques vary depending on the size and location of defects, along with factors such as intracranial pressure and patient co-morbidities. Large skull base defects require multilayer reconstruction that include a watertight primary dural repair with either synthetic or autologous tissue, followed by local vascularized tissue flaps.\u0000\u0000This review contains 8 figures, 2 videos, 4 tables and 33 references\u0000Key words: Anterior skull base, meningioma, esthesioneuroblastoma, chordoma, pituitary, CSF leak, nasosptal flap, dural repair, expanded endonasal approaches, endoscopic surgery","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127694964","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}
Facial attractiveness relies on a balance between the nose, cheekbones, and chin. An increasingly visual world with social media, teleconferencing, and online interactions heighten the demand for procedures that deliver facial harmony. Aesthetic facial augmentation changes the facial shape, establishes a more youthful appearance, and de-emphasizes unpleasant facial prominences, ultimately elevating one’s confidence. Facial implants provide a long-term solution to creating facial harmony and can be combined with other facial rejuvenation procedures at low morbidity. After studying this article, the participant should be able to understand the principles and practice of facial implant surgery, with particular attention to implants of the chin and midface. This review contains 9 figures, 6 tables and 32 references Keywords: aesthetic surgery, aging face, biomaterial, chin, facial analysis, facial augmentation, facial implant, facial rejuvenation, injectable filler, midface
{"title":"Chin and Malar Augmentation","authors":"John J. Chi, Nneoma S. Wamkpah","doi":"10.2310/ot.7096","DOIUrl":"https://doi.org/10.2310/ot.7096","url":null,"abstract":"Facial attractiveness relies on a balance between the nose, cheekbones, and chin. An increasingly visual world with social media, teleconferencing, and online interactions heighten the demand for procedures that deliver facial harmony. Aesthetic facial augmentation changes the facial shape, establishes a more youthful appearance, and de-emphasizes unpleasant facial prominences, ultimately elevating one’s confidence. Facial implants provide a long-term solution to creating facial harmony and can be combined with other facial rejuvenation procedures at low morbidity. After studying this article, the participant should be able to understand the principles and practice of facial implant surgery, with particular attention to implants of the chin and midface.\u0000\u0000This review contains 9 figures, 6 tables and 32 references\u0000Keywords: aesthetic surgery, aging face, biomaterial, chin, facial analysis, facial augmentation, facial implant, facial rejuvenation, injectable filler, midface","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122485405","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}
Elizabeth Erickson‐DiRenzo, Christine M. Kim, C. Sung
Presbylarynx refers to age-related structural changes of the vocal folds that include muscle atrophy, reduced neuromuscular control, loss of superficial lamina propria layer, and reduced pliability. The changes result in thin and bowed vocal folds, increased vocal effort requirements, breathy voice, change in habitual pitch, and strain. The primary treatment options are voice therapy focused on strengthening breath support and the intrinsic muscles of the larynx, and optimization of resonance; injection augmentation of the vocal folds; and type I thyroplasty. Functional dysphonia is defined as change in voice quality in the absence of structural or neurological abnormalities of the larynx. Muscle tension dysphonia (MTD) is a subtype of functional voice disorders and involves laryngeal muscle tension imbalance due to excessive or dysregulated activation resulting often in strained or breathy voice. MTD can be divided into primary (psychological etiology or vocal misuse) and secondary (compensatory for organic laryngeal pathology). The mainstay of treatment for MTD is voice therapy, along with medical or surgical treatment of the underlying vocal pathology in secondary MTD. Mutational falsetto, or puberphonia, is a functional voice disorder where a high-pitched, pre-adolescent voice fails to transition to the lower pitch of adulthood. This review contains 5 figures, 7 tables, 4 videos and 10 references Key Words: Presbylarynx, Injection augmentation, Type I thyroplasty, Primary muscle tension dysphonia, Secondary muscle tension dysphonia, Muscle tension patterns, Manual circumlaryngeal therapy, Functional dysphonia, Mutational falsetto
{"title":"Presbylarynx, Functional Voice Disorders, Muscle Tension Dysphonia","authors":"Elizabeth Erickson‐DiRenzo, Christine M. Kim, C. Sung","doi":"10.2310/ot.7065","DOIUrl":"https://doi.org/10.2310/ot.7065","url":null,"abstract":"Presbylarynx refers to age-related structural changes of the vocal folds that include muscle atrophy, reduced neuromuscular control, loss of superficial lamina propria layer, and reduced pliability. The changes result in thin and bowed vocal folds, increased vocal effort requirements, breathy voice, change in habitual pitch, and strain. The primary treatment options are voice therapy focused on strengthening breath support and the intrinsic muscles of the larynx, and optimization of resonance; injection augmentation of the vocal folds; and type I thyroplasty. Functional dysphonia is defined as change in voice quality in the absence of structural or neurological abnormalities of the larynx. Muscle tension dysphonia (MTD) is a subtype of functional voice disorders and involves laryngeal muscle tension imbalance due to excessive or dysregulated activation resulting often in strained or breathy voice. MTD can be divided into primary (psychological etiology or vocal misuse) and secondary (compensatory for organic laryngeal pathology). The mainstay of treatment for MTD is voice therapy, along with medical or surgical treatment of the underlying vocal pathology in secondary MTD. Mutational falsetto, or puberphonia, is a functional voice disorder where a high-pitched, pre-adolescent voice fails to transition to the lower pitch of adulthood.\u0000\u0000This review contains 5 figures, 7 tables, 4 videos and 10 references\u0000Key Words: Presbylarynx, Injection augmentation, Type I thyroplasty, Primary muscle tension dysphonia, Secondary muscle tension dysphonia, Muscle tension patterns, Manual circumlaryngeal therapy, Functional dysphonia, Mutational falsetto ","PeriodicalId":214685,"journal":{"name":"DeckerMed Otolaryngology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130815012","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：