No abstract available.
Laryngoplasty*

Background. Simulators in laryngology are an essential part of training. They provide an avenue for medical students and resident trainees to practice valuable psychomotor skills outside the realm of an actual patient encounter - thereby decreasing the risk of possible patient morbidity. Herein we present three locally manufactured simulation devices that can be used to train residents in laryngology procedures.

Objective. To present three simulation platform devices (Laser Box, Flexible Endoscopy Simulation, Thiel Cadaver Chair) and their applications in simulation-based learning

Methods. The Laser Box, Flexible Endoscopy Simulation, and Thiel Cadaver Chair were manufactured by outside parties designated as 'Laser Machinists'.

Results. Ten (10) units of the Laser Box, two (2) units of the Thiel Cadaver Chair, and two (2) units of the Flexible Endoscopy Simulation were constructed. They were used in a laryngology postgraduate course in our institution to teach the participants on endoscopies and laser phonosurgery.

Conclusion. Simulation for otolaryngologic procedures should be an essential part of training. The learning curve for procedures such as laryngoscopy and laser phonosurgery can be addressed with the production of simulation platforms. Most institutions in the Philippines still adopt the "see one, do one, teach one" approach, which lacks standardization and puts patients at risk. Various task trainers for laser phonosurgery and flexible endoscopy have been reported in the literature, but there seems to be no published data on the use of a cadaver chair for simulation. In the COVID-19 era, aside from being excellent teaching tools, simulation platforms derive their importance in helping train residents, educate medical students, and review consultants - maximizing skill development - and thereby decreasing repeated attempts, and indirectly, exposure to the SARS-CoV-2. Future validation studies are required for the models, with the eventual long-term goals to further standardize training, increase patient safety and incorporate a simulation-based curriculum for the specialty locally.

Humans ; Injections ; Laryngoplasty ; Vocal Cord Paralysis ; surgery

BACKGROUND AND OBJECTIVES: Though voice therapy is proven to be effective in academia, treatment results and satisfaction level are inconsistent in clinics. The inconsistency may rise from diverse vocal cords misuse patterns in patient population as they suffer from different diseases or have bad phonation habits. In order to overcome the limitation, we uniformized patients' vocal cords with injection laryngoplasty prior to voice therapy. The efficacy of voice therapy and consistency in treatment results after injection laryngoplasty were assessed. MATERIALS AND METHODS: Patients diagnosed with vocal nodules were either treated with injection laryngoplasty followed by voice therapy (combined treatment group) or voice therapy only (voice therapy group). Each group consisted of 15 patients. Acoustic measures (jitter, shimmer, NHR), aerodynamic measures (MPT, Psub, MAFR), and subjective auditory conscious measures (K-VHI, K-VRQOL) between two groups were analyzed. RESULTS: After treatments, both groups improved in terms of acoustic, aerodynamic, and subjective auditory conscious measures compared to pre-treatment. Combined treatment group had statistically significantly greater improvement in shimmer, P in K-VHI, and PF in K-VRQOL compared to voice therapy group. CONCLUSION: Injection laryngoplasty treatment prior to voice therapy synergizes in treating patients compared to voice therapy only.
Acoustics ; Humans ; Laryngoplasty ; Phonation ; Vocal Cords ; Voice*

Humans ; Injections ; Laryngoplasty ; methods ; trends ; Vocal Cords

In the past decade, vocal fold injection (VFI) has re-emerged as a valuable treatment modality for a variety of laryngeal disorders. It offers many advantages for the treatment of glottal insufficiency. It can avoid surgical scar and is easily performed with local anesthesia. In this article, we describe the indication of injection laryngoplasty, variable injection materials and discuss about vocal fold injection approaches.
Anesthesia, Local ; Cicatrix ; Laryngoplasty ; Vocal Cords ; Voice ; Voice Disorders

This is a case of a 37 ear old female who as scheduled to undergo thyroplassty for left vocal cord paralysis due to chronic focal mononeuropathy of the left recurrent laryngeal nerve. Correct placement of the implant would be verified by awakening the patient at a predetermined time and asking her to phonate. This was accomplished under balanced anesthesia using mask inhalation of titrated concentration of sevoflurane and contunous intravenous infusion of dexmedetomidine.
Human ; Female ; Adult ; VOCAL CORD PARALYSIS ; LARYNGOPLASTY ; MONONEUROPATHIES ; DEXMEDETOMIDINE

Objective: To present the case of a 78-year-old man with Glottic SCCa stage I who underwent single stage transoral cordectomy type IV with medialization thyroplasty under general anesthesia. Methods: Design: Case Report. Setting: Tertiary Government Training Hospital. Patient: One. Results: Postoperatively, patient was able to phonate and gave a VHI score of 12 and GRBAS score of 4. He was able to resume oral feeding without any signs of aspiration. Postoperative flexible laryngoscopy showed fully mobile vocal cords with good approximation in the midline. Conclusion This report suggests that vocal cord medialization via thyroplasty may be performed after cordectomy in a single stage, providing acceptable postoperative voice as well as good swallowing outcome
Laryngoplasty ; Laryngeal Neoplasms ; Carcinoma, Squamous Cell ; Glottis ; Vocal Cords

BACKGROUND AND OBJECTIVES: In unilateral vocal fold paralysis (VFP), medialization thyroplasty (MT), arytenoid adduction (AA) and injection layrngoplasty (IL) are the most common procedures to correct phonatory problems. There is no consensus that which procedure is superior to the other for correcting the glottal insufficiency. The purpose of this study was to compare the phonatory parameters between MT, AA and AA with IL (AA+IL) in patients with unilateral VFP. MATERIALS AND METHODS: This retrospective study enrolled patients from 2005 to 2016. Total 72 patients (49 male, 23 female, mean age 54.5 years) were classified into three groups ; MT (n=28), AA (n=12), and AA+IL (n=32). GRBAS scales, maximum phonation time (MPT), jitter, shimmer, noise to harmonic ratio (NHR), and voice handicap index (VHI)-10 and VHI-30 were preoperatively and postoperatively collected and compared between the three groups. RESULTS: Age, gender and cause of VFP were not significantly different between the three groups. In MT and AA groups, MPT, VHI, G (overall grade) and B (breathiness) were significantly improved. In AA+IL group, jitter, shimmer, NHR, MPT, VHI, G and B were significantly improved. In analysis of differences (pre-postoperative values), Δ jitter (p < 0.001), Δ shimmer (p=0.031), and Δ NHR (p=0.002) were significantly different and AA+IL group showed the greatest improvement. CONCLUSION: Analysis of voice parameters showed that all the three procedures for patients with unilateral VFP are effective in the improvement of voice ; especially in MPT, VHI-10, G and B scales. Compared to the others, AA+IL provided the better acoustic values including jitter, shimmer and NHR.
Acoustics ; Consensus ; Female ; Humans ; Laryngoplasty* ; Male ; Noise ; Paralysis* ; Phonation ; Retrospective Studies ; Vocal Cords* ; Voice* ; Weights and Measures

BACKGROUND AND OBJECTIVES: The clinical reports for the treatment of vocal fold scar and sulcus vocalis are limited, also there is no best one for the treatment of them. This study is to evaluate the effect of Injection laryngoplasty (IL) for the treatment of vocal fold scar and sulcus vocalis. MATERIALS AND METHODS: from January 2013 to May 2015, the Nineteen patients who were diagnosed as vocal fold scar, sulcus and atrophy, and underwent IL, were engaged in this study. Clinical information and voice parameters were analyzed by retrospective chart review. Pre and post voice parameters were compared. RESULTS: Subgroups of diagnosis were classified into sulcus vocalis for 12 patients, vocal fold scar for 5, and atrophy for 2. IL was performed under local anesthesia through cricothyroid membrane except one patient. Atesense®, Radiessess®, and Rofilan® were used as injected materials in 9, 9, and 1 patients respectively. Maximal phonation time (p=0.0124), dynamic range (p=0.0028), pitch range (p=0.0141), voice handicap index (p=0.028), glottal closure (p=0.0229), and mucosal wave (p=0.0132) had significant improvement for post-IL voice assessment than Pre-IL. While GRBAS, Mean flow rate, Jitter, Shimmer, Harmony to Noise ratio didn't have improvement. CONCLUSION: IL is a feasible option for the treatment of glottis incompetence with normally mobile vocal folds such as sulcus vocalis and vocal fold scar.
Anesthesia, Local ; Atrophy ; Cicatrix* ; Diagnosis ; Glottis ; Humans ; Laryngoplasty* ; Membranes ; Noise ; Phonation ; Retrospective Studies ; Vocal Cords* ; Voice