Journal of voice : official journal of the Voice Foundation
-
Arytenoid cartilage dislocation is an infrequently diagnosed cause of vocal fold immobility. Seventy-four cases have been reported in the literature to date. Intubation is the most common origin, followed by external laryngeal trauma. ⋯ This process may result in significant voice improvement even long after the dislocation. Strobovideolaryngoscopy, laryngeal electromyography, and laryngeal computed tomography (CT) imaging are helpful in the evaluation of patients with vocal fold immobility to help distinguish arytenoid cartilage dislocation from vocal fold paralysis. Familiarity with signs and symptoms of arytenoid cartilage dislocation and current treatment techniques improves the chances for optimal therapeutic results.
-
High-frequency subglottic jet ventilation was used in 142 consecutive adults with grade I airways treated with suspension microlaryngoscopy. All cases were managed by the senior anesthesiologist (AP) and the large majority by the senior surgeon (JR), between 2000 and 2002. The laser was used in 30% of cases. ⋯ The subglottic catheter never proved impossible to insert and only needed to be replaced by the supraglottic catheter in two patients because of limitation of visualization of the posterior glottis. The technique was used in a wide variety of surgical pathology from benign hyperfunction-related laryngeal pathology through paralytic vocal fold conditions through papilloma. Advantages and disadvantages over traditional intubation techniques and supraglottic jet ventilation are reviewed, including such issues as ease of intubation/ventilation, surgical exposure/control, maintenance of O2 and CO2 levels, and use in the limited/borderline airway.
-
A single subject design was used to determine if pressure threshold training strengthens the inspiratory muscles in a subject with a limited glottal airway as well as diminish dyspnea and improve parameters of speech. The subject was a 19-year-old woman whose glottal airway was limited due to bilateral abductor vocal fold paralysis following a thyroidectomy. A 5-week inspiratory muscle strength-training program was implemented using a pressure-threshold trainer to strengthen the inspiratory muscles with the intent of enabling the generation of higher inspiratory pressures. ⋯ Dyspnea during exercise and speech decreased as reported by the subject. Total reading duration and pause duration demonstrated a declining trend during connected speech. The results indicated that inspiratory muscle training using a pressure threshold device improves functional tasks such as exercise and speech in a subject with upper airway limitation.
-
A national survey was conducted to identify factors associated with untrained singing talent based on perceptions obtained from a homogeneous group of professional singing pedagogues. Survey items included questions related to the perception of singing talent, factors associated with untrained singing talent, and physiological variables that distinguished untrained singing talented individuals from those without obvious singing talent. ⋯ Environmental influences and genetics were rated most important for explaining why one individual would express singing talent and another would not. In addition, the data suggested that abilities related to the control of pitch distinguished untrained talented individuals from those without singing talent more than other physiological variables.
-
At a physiological level, the act of singing involves control and coordination of several systems involved in the production of sound, including respiration, phonation, resonance, and afferent systems used to monitor production. The ability to produce a melodious singing voice (eg, in tune with accurate pitch) is dependent on control over these motor and sensory systems. To test this position, trained singers and untrained subjects with and without expressed singing talent were asked to match pitches of target pure tones. ⋯ Results revealed trained singers and untrained subjects with singing talent were no different in their pitch-matching abilities when measured before or after external feedback could be utilized. The untrained subjects with singing talent were also significantly more accurate than the trained singers when external auditory feedback was masked. Both groups were significantly more accurate than the untrained subjects without singing talent.