Treatments for voice disorders consist of surgical intervention, medical intervention, and voice therapy. Voice therapy has primarily been applied in cases of nonorganic dysphonia, including muscle tension dysphonia and mutational falsetto. However, the application of voice therapy has recently expanded to include benign vocal fold lesions, presbyphonia, and vocal fold paralysis, among other targets. Otolaryngologists need to determine the appropriateness of the application of voice therapy and thus must be familiar with the evidence supporting voice therapy. In addition, to facilitate voice therapy, it is important for a speech language pathologist (SLP) to attend medical examinations performed by an otolaryngologist. This enables otolaryngologists and SLPs to share knowledge concerning the patient’s laryngeal function as well as the patient’s wishes. These will create synergy that will promote effective patient care.
{"title":"Importance of Cooperation between Otolaryngologists and Speech Language Pathologists","authors":"Masanobu Mizuta, T. Haji, Chika Abe","doi":"10.5426/larynx.33.174","DOIUrl":"https://doi.org/10.5426/larynx.33.174","url":null,"abstract":"Treatments for voice disorders consist of surgical intervention, medical intervention, and voice therapy. Voice therapy has primarily been applied in cases of nonorganic dysphonia, including muscle tension dysphonia and mutational falsetto. However, the application of voice therapy has recently expanded to include benign vocal fold lesions, presbyphonia, and vocal fold paralysis, among other targets. Otolaryngologists need to determine the appropriateness of the application of voice therapy and thus must be familiar with the evidence supporting voice therapy. In addition, to facilitate voice therapy, it is important for a speech language pathologist (SLP) to attend medical examinations performed by an otolaryngologist. This enables otolaryngologists and SLPs to share knowledge concerning the patient’s laryngeal function as well as the patient’s wishes. These will create synergy that will promote effective patient care.","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127512281","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}
Vocal fold scarring and sulcus vocalis remain major therapeutic challenges in voice therapy. The loss of the superior lamina propria results in a change to the pliability of the vocal folds, along with changes in the glottal configuration and glottal closure and a reduced to absent mucosal wave motion. This results in dysphonia of varying severity, including breathiness, roughness, loss of pitch range, and flexibility. The dysphonia caused by vocal fold scarring and sulcus vocalis is often severe and difficult to treat, and no suitable voice therapy has been established, let alone validated in a prospective study. We performed voice therapy for patients with mild to moderate vocal fold scarring and sulcus vocalis and functional problems, such as an alternative hyperfunc-tional voice or vocal misuse. The concept of voice therapy in our clinic involved the following: minimizing vocal effort, optimizing the vocal quality, and developing vocal flexibility. As a result, the vocal function has signifi-cantly improved with regard to various vocal parameters in aerodynamic assessments, acoustic analyses, stro-boscopic examinations, and self-evaluations. Ten of 13 patients completed treatment for vocalization through voice therapy, without the need for additional treatments. Three of the 13 patients showed an improvement in their vocal function on inspection, although they were not satisfied with their professional voices. These results indicate that voice therapy has potential utility for improving the vocal function in patients with mild to moderate vocal fold scarring and sulcus vocalis.
{"title":"Voice Therapy Management of Vocal Fold Scarring and Sulcus Vocalis","authors":"M. Kaneko","doi":"10.5426/larynx.33.184","DOIUrl":"https://doi.org/10.5426/larynx.33.184","url":null,"abstract":"Vocal fold scarring and sulcus vocalis remain major therapeutic challenges in voice therapy. The loss of the superior lamina propria results in a change to the pliability of the vocal folds, along with changes in the glottal configuration and glottal closure and a reduced to absent mucosal wave motion. This results in dysphonia of varying severity, including breathiness, roughness, loss of pitch range, and flexibility. The dysphonia caused by vocal fold scarring and sulcus vocalis is often severe and difficult to treat, and no suitable voice therapy has been established, let alone validated in a prospective study. We performed voice therapy for patients with mild to moderate vocal fold scarring and sulcus vocalis and functional problems, such as an alternative hyperfunc-tional voice or vocal misuse. The concept of voice therapy in our clinic involved the following: minimizing vocal effort, optimizing the vocal quality, and developing vocal flexibility. As a result, the vocal function has signifi-cantly improved with regard to various vocal parameters in aerodynamic assessments, acoustic analyses, stro-boscopic examinations, and self-evaluations. Ten of 13 patients completed treatment for vocalization through voice therapy, without the need for additional treatments. Three of the 13 patients showed an improvement in their vocal function on inspection, although they were not satisfied with their professional voices. These results indicate that voice therapy has potential utility for improving the vocal function in patients with mild to moderate vocal fold scarring and sulcus vocalis.","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125277889","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}
Kiminori Sato, S. Chitose, F. Sato, Kiminobu Sato, T. Ono, H. Umeno
There is growing evidence that the cells in the maculae flavae are tissue stem cells and that the maculae flavae are a stem cell niche of the human vocal fold mucosa. The stem cell system of the tissue stem cells of the human adult and newborn vocal fold mucosa, including the heterogeneity and hierarchy of the cells, was re-viewed and summarized. Regarding the heterogeneity, cobblestone-like polygonal cells, vocal fold stellate cell-like cells possessing lipid droplets in the cytoplasm and fibroblast-like spindle cells were intermingled in the maculae flavae under light and electron microscopy, indicating that three phenotypes of cells were present in the human adult and newborn maculae flavae in vivo. Regarding the hierarchy, cobblestone-like polygonal cells are at the top, while fibroblast-like spindle cells are at the bottom of the cellular hierarchy in the stem cell system. Therefore, vocal fold stellate cell-like cells in the human maculae flavae are likely at the second level of the cellular hierarchy. This suggests that the vocal fold stellate cell-like cells are progenitor cells or transiently amplifying cells in the stem cell system of the human vocal fold mucosa. The cells in the maculae flavae of the human adult and newborn vocal fold mucosa have heterogeneity and hierarchy in the stem cell system in vivo.
{"title":"Heterogeneity and Hierarchy of Tissue Stem Cells in the Human Vocal Fold Mucosa","authors":"Kiminori Sato, S. Chitose, F. Sato, Kiminobu Sato, T. Ono, H. Umeno","doi":"10.5426/larynx.33.191","DOIUrl":"https://doi.org/10.5426/larynx.33.191","url":null,"abstract":"There is growing evidence that the cells in the maculae flavae are tissue stem cells and that the maculae flavae are a stem cell niche of the human vocal fold mucosa. The stem cell system of the tissue stem cells of the human adult and newborn vocal fold mucosa, including the heterogeneity and hierarchy of the cells, was re-viewed and summarized. Regarding the heterogeneity, cobblestone-like polygonal cells, vocal fold stellate cell-like cells possessing lipid droplets in the cytoplasm and fibroblast-like spindle cells were intermingled in the maculae flavae under light and electron microscopy, indicating that three phenotypes of cells were present in the human adult and newborn maculae flavae in vivo. Regarding the hierarchy, cobblestone-like polygonal cells are at the top, while fibroblast-like spindle cells are at the bottom of the cellular hierarchy in the stem cell system. Therefore, vocal fold stellate cell-like cells in the human maculae flavae are likely at the second level of the cellular hierarchy. This suggests that the vocal fold stellate cell-like cells are progenitor cells or transiently amplifying cells in the stem cell system of the human vocal fold mucosa. The cells in the maculae flavae of the human adult and newborn vocal fold mucosa have heterogeneity and hierarchy in the stem cell system in vivo.","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125319109","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 laryngeal cleft is a rare congenital malformation of the posterior laryngeal or laryngotracheal wall with an incidence of ≦ 0.1%. Since it presents with symptoms of dysphagia, aspiration pneumonia, and hoarseness in early childhood, many patients with laryngeal clefts are often diagnosed in infancy. We herein report a rare case involving an adult patient with a typeII-laryngeal cleft who underwent endoscopic repair and showed improvement in dysphagia. The characteristic findings on laryngeal endoscopy of this disease include enlargement of the inter-arytenoid region and redundant soft tissue overlying the arytenoid cartilages that prolapses into the cleft (ram sign) as well as a gap behind the vocal process during vocalization. Otolaryngologists need to be aware of this characteristic finding, since the disease is often overlooked.
{"title":"A Rare Case of Congenital Laryngeal Cleft in an Adult that Showed Effective Improvement in Dysphagia with Endoscopic Repair","authors":"Ryota Takagi, Naruhiko Kai, Kaori Tanaka, N. Hato","doi":"10.5426/larynx.33.224","DOIUrl":"https://doi.org/10.5426/larynx.33.224","url":null,"abstract":"A laryngeal cleft is a rare congenital malformation of the posterior laryngeal or laryngotracheal wall with an incidence of ≦ 0.1%. Since it presents with symptoms of dysphagia, aspiration pneumonia, and hoarseness in early childhood, many patients with laryngeal clefts are often diagnosed in infancy. We herein report a rare case involving an adult patient with a typeII-laryngeal cleft who underwent endoscopic repair and showed improvement in dysphagia. The characteristic findings on laryngeal endoscopy of this disease include enlargement of the inter-arytenoid region and redundant soft tissue overlying the arytenoid cartilages that prolapses into the cleft (ram sign) as well as a gap behind the vocal process during vocalization. Otolaryngologists need to be aware of this characteristic finding, since the disease is often overlooked.","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125344492","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":"Management of Dysphonia in the Elderly and Presbyphonia : Physiology and Evaluation","authors":"A. Yamauchi","doi":"10.5426/larynx.33.135","DOIUrl":"https://doi.org/10.5426/larynx.33.135","url":null,"abstract":"","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"475 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125837052","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":"Intensive Voice Therapy for Patients with Dysphonia","authors":"M. Kaneko, Y. Sugiyama, Shigeru Hirano","doi":"10.5426/larynx.33.200","DOIUrl":"https://doi.org/10.5426/larynx.33.200","url":null,"abstract":"","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128762017","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":"Treatment of Bilateral Vocal Cord Paralysis - Focusing on the Ejnell Method Under the Video-laryngoscope -","authors":"Hirotaka Hara","doi":"10.5426/larynx.33.104","DOIUrl":"https://doi.org/10.5426/larynx.33.104","url":null,"abstract":"","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116989951","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. Chitose, H. Umeno, M. Fukahori, T. Kurita, S. Hamakawa, S. Sueyoshi, Kiminobu Sato, T. Ono, Kiminori Sato
Thyroplasty type I (TPI) and arytenoid adduction (AA) in laryngeal framework surgery, as developed by Isshiki, have been the surgeries of choice for unilateral vocal fold paralysis (UVFP). This paper mainly de-scribes the surgical indications and techniques of these surgeries performed in our department. When performing TPI, it is important to correctly open the window in the thyroid cartilage and preserve its inner perichon-drium. It is also necessary to devise a way to deal with osteochondral lesions found in the thyroid cartilage. However, a more reliable and less invasive way of approaching the muscle process of the arytenoid cartilage when performing AA is sought. Using preoperative three-dimensional reconstructed computed tomography (3DCT) images, we can determine the fenestration position during TPI. Furthermore, by evaluating the loca-tions of inserted material after TPI or arytenoid cartilage after AA using postoperative 3DCT images, we can obtain feedback on who to further improve our surgical technique.
{"title":"Laryngeal Framework Surgeries for Patients with Unilateral Vocal Fold Paralysis","authors":"S. Chitose, H. Umeno, M. Fukahori, T. Kurita, S. Hamakawa, S. Sueyoshi, Kiminobu Sato, T. Ono, Kiminori Sato","doi":"10.5426/larynx.33.155","DOIUrl":"https://doi.org/10.5426/larynx.33.155","url":null,"abstract":"Thyroplasty type I (TPI) and arytenoid adduction (AA) in laryngeal framework surgery, as developed by Isshiki, have been the surgeries of choice for unilateral vocal fold paralysis (UVFP). This paper mainly de-scribes the surgical indications and techniques of these surgeries performed in our department. When performing TPI, it is important to correctly open the window in the thyroid cartilage and preserve its inner perichon-drium. It is also necessary to devise a way to deal with osteochondral lesions found in the thyroid cartilage. However, a more reliable and less invasive way of approaching the muscle process of the arytenoid cartilage when performing AA is sought. Using preoperative three-dimensional reconstructed computed tomography (3DCT) images, we can determine the fenestration position during TPI. Furthermore, by evaluating the loca-tions of inserted material after TPI or arytenoid cartilage after AA using postoperative 3DCT images, we can obtain feedback on who to further improve our surgical technique.","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"630 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132915101","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":"Subglottic Stenosis in Children","authors":"N. Morimoto","doi":"10.5426/larynx.33.89","DOIUrl":"https://doi.org/10.5426/larynx.33.89","url":null,"abstract":"","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124848413","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":"Clinical Assessment of Cuffed Endotracheal Tube by Ultra-high-resolution Computed Tomography","authors":"M. Miyamoto, I. Watanabe, H. Nakagawa, K. Saito","doi":"10.5426/larynx.33.206","DOIUrl":"https://doi.org/10.5426/larynx.33.206","url":null,"abstract":"","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116237412","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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