OBJECTIVE/strong: To design and test an improvised tracheotomy speaking valve fabricated from recycled parts of an anesthesia airway breathing circuit.br /br /strongMETHODS/strong: br /strongDesign/strong: Surgical Instrumentationbr /strongSetting/strong: Tertiary Private Hospitalbr /strongSubjects/strong: Speaking valves fabricated from discarded anesthesia breathing circuit parts were pilot-tested on three patients: one with vocal fold paralysis, another with a supraglottic mass and one post hemi-laryngectomy. br /br /strongRESULTS/strong: The improvised tracheotomy speaking valve was inexpensive and relatively easy to assemble. All three patients tolerated speech well through the speaking valve and were pleased to reestablish their means of verbal communication. Maximum Phonation Time (MPT) averaged 8 seconds for all three subjects.br /br /strongCONCLUSION/strong: In our local setting, improving the quality of life of tracheotomized patients should be accessible to all, hence the value of an improvised speaking valve. It provides a more affordable means of restoring speech and because it is made from recycled materials, it is eco-friendly. Our improvised speaking valve is also a cheaper but viable alternative to more expensive commercially available ones. Clinical trials with standardized feedback questionnaires, multi-observer perceptual evaluation with a system such as the GRBAS and/or vocal acoustic measures in a speech laboratory should be made to assess long term use, efficiency and safety measures./p
Tracheotomy ; Surgical Procedures, Operative ; instrumentation-surgery

Objective: To describe the vocal acoustic measures of nonsmoking Filipino young adults without voice complaints at a private tertiary hospital in Quezon City; to determine if our baseline values are distributed normally and comparable to data in similar studies done abroad; and to recommend normative voice parameters which may be used as baseline data in our institution and for comparison in future studies. Methods: Design: Cross-sectional study Setting: Private tertiary hospital Participants: A total of 70 subjects were recruited at random. Results: Values extracted for f0, Jitter %, Jitter dB, Shimmer %, Shimmer dB and NHR showed normal distribution of results. The average vocal acoustic values found in the present study for male voices producing the vowel /a/ were fo = 130.6 ± 13.65Hz, jitter = 0.0.46 % ± 0.184, jitter dB: 37.62dB ± 16.664, shimmer %= 0.23%, shimmer dB=0.23 ± 0.67 and NHR = 0.13 ± 0.010. The average values found for female voices, producing the vowel /a/ were fo = 218.38 ± 26.192Hz, jitter = 0.87% ± 0.61, jitter dB: 34.82 ± 22.5, shimmer %= 2.72 ± 1.07 shimmer dB=0.23db ± 0.67 and NHR = 0.12dB ± 0.016. Values retrieved from this study show similar trends with other papers abroad. Conclusions Voice acoustic systems are composed of different recording criteria, recording instrumentations and algorithms which primarily cause the differences in the results obtained in various studies, thus precluding a single normalization. Following international recommendations for individual normalization per institution, we have obtained our own values. Our data was comparable to the results of other international studies. However further investigation is recommended in areas where possibilities of interdialectic variation may produce an effect on the outcome of the study.
Human ; Male ; Female ; Middle Aged ; Adult ; Acoustics ; voice ; Speech Acoustics ; Weights and Measures

OBJECTIVE: To present a case of arteriovenous malformation of the mandible in a young postpartum woman and discuss the diagnostic and therapeutic dilemmas involved.

METHODS:

          Design: Case Report

          Setting: Tertiary Private Teaching Hospital

          Participant: One (1)

RESULT: A 27-year-old woman with left mandibular swelling two weeks after tooth extraction was diagnosed and managed as a case of arteriovenous malformation. The extent of the lesion prevented surgical intervention and bleeding recurred despite three embolization attempts. Ultimately, the left external carotid artery and contralateral dorsal contributory vessel were sacrificed causing necrosis of the anterior tongue and its eventual detachment. Three sessions of stereotactic radiosurgery eventually controlled the bleeding with no recurrence to date.

CONCLUSION: On her second month following stereotactic radiosurgery, there appeared to be no complete resolution of the AVM but there was also no recanalization or regrowth of the lesion. Uncertain about whether her arteriovenous malformation will revascularize and how we may be able to help her in the event that it does, the waiting game continues for our patient.

 

 

Human ; Arteriovenous Malformations ; Mandible ; Vascular Malformations