Humans ; Laryngopharyngeal Reflux ; diagnosis ; therapy

Adult ; Aged ; Aged, 80 and over ; Granuloma ; drug therapy ; Humans ; Laryngeal Diseases ; drug therapy ; Male ; Middle Aged

OBJECTIVETo study the diagnosis and treatment of varices of the vocal cord.

METHODSThe clinical data of 21 cases with varix of vocal cord were analyzed. All the patients presented hoarseness. There were 15 female and 6 male cases with their ages ranged from 23 to 68 years (median 44 years old). The varix was found on the right vocal cord in 12 cases, on the left vocal cord in 9 cases. Isolated varix existed on the vocal cord in 10 cases, varix with vocal cord polyps or nodules in 10 cases, varix with vocal cord paralysis in 1 case.

RESULTSAll the patients were diagnosed under the laryngovideoscopy. The lesions appeared on the superior surface of the vocal cord. Varices manifested as abnormally dilated capillary running in the anterior to posterior direction in 6 cases, as clusters of capillary in 3 cases, as a dot or small sheet or short line of capillary in 12 cases. The varices were disappeared in 2 of 8 cases with vocal cord varices and polyps after removed the polyps. The varices of others patients had no change after following up for more than 6 months, but one patient happened hemorrhage of the contralateral vocal cord.

CONCLUSIONSVarices are most commonly seen in female. Laryngovideoscopy is the key in determining the vocal fold varices. Management of patients with a varix includes medical therapy, speech therapy, and occasionally surgical vaporization.

Adult ; Aged ; Female ; Humans ; Laryngoscopy ; Male ; Middle Aged ; Varicose Veins ; diagnosis ; therapy ; Vocal Cords ; blood supply ; pathology ; Young Adult

OBJECTIVEThe consistency of reflux finding score (RFS) was studied by three different level of throat physicians.

METHODSOne hundred and ten laryngeal photos were chosen to assess the RFS test-retest reliability on two separate occasions at least more than one week.

RESULTSThe mean total RFS scores for doctor A were 9.05 ± 2.54, doctor B were 8.80 ± 2.20, doctor C were 8.98 ± 2.21 at the initial screening, and 9.20 ± 2.47, 9.03 ± 2.14 and 8.91 ± 2.30 respectively at the repeat evaluation. The test-retest reliability of total RFS scores of three doctors were 0.860, 0.800 and 0.837 respectively, P all <0.001. The test-retest reliability of each item scores for doctor A were from 0.662 to 1.000, doctor B were from 0.486 to 1.000 and doctor C were from 0.613 to 1.000. There were no differences in the total RFS scores comparing among each evaluation of the three doctors (χ(2) = 1.553, P = 0.907). Total RFS scores more than 7 were considered as abnormal. The interobsever consistency was as follows: A with B was 83.6% (κ = 0.617, P = 0.000), A with C was 85.5% (κ = 0.644, P = 0.000),B with C was 89.1% (κ = 0.720, P = 0.000). The intraobserver consistency was 91.8% (κ = 0.807, P = 0.000), 81.8% (κ = 0.534, P = 0.000), 90.9% (κ = 0.741, P = 0.000) respectively.

CONCLUSIONSThe result of this study shows that the assessment of RFS is not influenced by different educational backgrounds and clinical experience.RFS can be applied widely in China.

China ; Gastroesophageal Reflux ; classification ; diagnosis ; Humans ; Larynx ; Neck ; Pharynx ; Reproducibility of Results ; Severity of Illness Index

OBJECTIVETo observe the clinical shapes of vocal cord polyps and their pathological features.

METHODSThe laryngoscopic photographs of 156 patients with vocal cord polyps were reviewed. All patients received phonomicrosurgery. Eighty eight males and 68 females were included. Their ages ranged from 14 to 76 years (median 43.0 years). The clinical courses of the diseases were 1 to 132 months (median 6.5 months). There were 57 cases with right vocal cord polyps, 61 cases with left vocal cord polyps, 38 cases with bilateral vocal cord polyps. The vocal cord polyps with pedicles were found in 27 cases, without pedicles in 129 cases. The specimens of the vocal cord polyps were fixed in formalin solution and embedded in paraffin. Sections were cut, stained with HE method, and observed under light microscope.

RESULTSThe vocal cord polyps were classified into 5 types according to the clinical shapes of vocal cord polyps and their pathological features: edematous type in 70 cases (44.9%), vascular type in 49 cases (31.4%), fibrous type in 15 cases (9.6%), hemorrhagic or thrombotic type in 13 cases (8.3%), and amyloid type in 9 cases (5.8%). The clinical courses among the five types of vocal cord polyps had no statistic significance (P > 0.05).

CONCLUSIONSThe classification of the vocal cord polyp according to the clinical shapes of vocal cord polyps has clinical significance for the treatment. Some vocal cord polyps of edematous type, vascular type and hemorrhagic type can be cured with voice therapy. The vocal cord polyps of fibrous type and amyloid type need treatment with phonomicrosurgery. The differentiation diagnosis between amyloid type vocal cord polyps and vocal cord carcinoma should be made.

Adolescent ; Adult ; Aged ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; Laryngoscopy ; Male ; Middle Aged ; Polyps ; pathology ; Vocal Cords ; pathology ; Young Adult

OBJECTIVETo study the characteristics of surface electromyography (sEMG) during swallowing in normal adults.

METHODSThe sEMG during swallowing was carried out in 126 normal adults. There were 66 males and 60 females with their age ranged from 18 to 65 years. The recording electrodes were placed on the skin above the superior thyroid notch and the duration and amplitude of muscle activities during every deglutition were recorded. Swallowing styles were dry swallow, 20 ml water swallow and 40 ml water swallow.

RESULTSThe durations of sEMG at dry swallow, 20 ml water swallow and 40 ml water swallow were (1.133 ± 0.209)s (x¯ ± s), (1.097 ± 0.208)s, and (1.510 ± 0.432)s, while the amplitudes were (0.332 ± 0.115)mV, (0.308 ± 0.095)mV, and (0.399 ± 0.139)mV in normal male group. The durations of sEMG at dry swallow, 20 ml water swallow and 40 ml water swallow were (1.118 ± 0.170)s, (1.085 ± 0.209)s, and (1.765 ± 0.463)s, while the amplitudes were (0.292 ± 0.100)mV, (0.261 ± 0.113)mV, and (0.342 ± 0.129)mV in normal female group. The amplitudes of sEMG in male were higher than those in female (P < 0.05) and the durations had no statistically significant difference between male and female (P > 0.05) in all swallow styles except that the duration of 40 ml water swallow in female was longer than that in male (P < 0.05). In all volunteers, the durations of sEMG at 40 ml water swallow were longer than those at dry swallow and 20 ml water swallow, and there was no statistically significant difference between dry swallow and 20 ml water swallow. The amplitude of sEMG at 40 ml water swallow was higher than that at dry swallow. The amplitude of sEMG in dry swallow was higher than that at 20 ml water swallow. There was no statistically significant difference in durations and amplitudes of sEMG among four different age groups of male. In the female groups, there was no statistically significant difference in durations and amplitudes of sEMG among four different age groups except that the duration at 40 ml water swallow was longer in younger group (<30 years old) than in older groups.

CONCLUSIONSSurface EMG of swallowing is a simple and noninvasive method for evaluating the swallowing function. The sEMG data of swallowing in normal adults obtained in this study may be used to provide reference for screening swallowing function in adults in the future.

Adolescent ; Adult ; Aged ; Deglutition ; Electrodes ; Electromyography ; Female ; Humans ; Male ; Middle Aged ; Skin ; Thyroid Cartilage ; Young Adult

OBJECTIVETo observe the habituation of seasickness in non marine subjects during a long voyage.

METHODSA crew of 106 staffs of the Hospital Ship Ark Peace was included in this study. There were 59 male and 47 female with an age ranged from 23 to 53 years (mean 37.2 years). They all took part in the Mission Harmony 2011 for medical service in four countries around the Caribbean Sea. Questionnaires and visual analogue scales (VAS) were used to investigate the prevalence and degree of the seasickness in different periods.

RESULTSThe prevalence of seasickness was 72.64% in the initial period of voyage. The prevalence and degree of seasickness in female and in staff with motion sickness history were higher and more severe than that in male and in staff without motion sickness history(P < 0.05). After two weeks, the prevalence and degree of seasickness decreased, which meant habituation of seasickness occurred. With the voyage going longer, the prevalence and degree of seasickness were further decreased, but the severe sea condition make the prevalence and degree of seasickness worse. The rate of habituation of seasickness was 62.33%, and the habituation rate of seasickness in male (76.92%) was higher than that in female (47.37%) (χ(2) = 7.161, P = 0.007).

CONCLUSIONSThe habituation of the seasickness occurred after two weeks in a long voyage. Male are easier to get habituation of seasickness than female. The severe sea condition influences the prevalence and degree of seasickness.

Acclimatization ; Adult ; Female ; Humans ; Male ; Middle Aged ; Motion Sickness ; physiopathology ; Naval Medicine ; Sex Factors ; Young Adult

OBJECTIVETo observe the morphologic features of cricopharyngeal muscle (CPM) under suspension laryngeal endoscope.

METHODSThis prospective study was conducted on a series of 100 consecutive patients who undergone endoscopic microlaryngeal surgery with intubation general anesthesia. The suspension laryngoscope was introduced down to postcricoid area approaching esophageal inlet. By lifting the larynx with the laryngoscope, the mucosa-covered cricopharyngeal muscle was easily identified as the mound of tissue just at the posterior pharyngeal wall. The image of cricopharyngeal muscle under the laryngoscope was saved.

RESULTSIn 94 out of 100 patients, CPM could be visualized with laryngoscope. In the other 6 patients, both CPM and glottic could not be exposed because of cervical vertebra stiffness and obesity. According to the image of CPM under the laryngoscope, the shape of the CPM was divided into three types. It was named for flat type in which there was no mound of tissue visible at the posterior pharyngeal wall and esophageal cavity could be visible completely, semi-bar type in which there was a bar at the posterior pharyngeal wall and partial esophageal cavity could be visible and full-bar type in which the bar contact esophageal anterior wall and esophageal cavity could not be visible. There were 14(14.9%) patients as flat type, 59(62.8%) as semi-bar type and 21(22.3%) as full-bar type. No significant difference was found between adults group and the aged (≥ 65 years old) group (χ(2) = 1.224, P = 0.747) and reflux associated group and non-reflux associated group respectively (χ(2) = 5.252, P = 0.072).

CONCLUSIONSThe CPM could be well exposed in most of the patients with suspension laryngeal endoscope. It provides anatomy basis for endoscopic cricopharyngeal myotomy.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Laryngeal Diseases ; pathology ; Laryngoscopy ; Male ; Middle Aged ; Pharyngeal Diseases ; pathology ; Pharyngeal Muscles ; pathology ; surgery ; Prospective Studies ; Young Adult

OBJECTIVETo obtain a series of objective criteria associated with pharyngeal swallowing function using dynamic swallow study in Chinese adults.

METHODSDynamic videofluoroscopic swallow studies were performed on 80 normal adult volunteers. There were 40 males and 40 females aged from 20 to 60 years old. Measurement software Avidemux 2.5 and Image J were used to measure the objective parameters which were closely related to the pharyngeal swallowing function in the swallowing process, such as maximum displacement of the hyoid bone (HmaxD), pharyngeal transit time (PTT), pharyngeal constriction ratio(PCR), and maximum opening of the esophageal entrance (EEmax).

RESULTSIn the 80 adults, the HmaxD, PTT, PCR, and EEmax were (1.91 ± 0.48) cm (x(-) ± s), (0.82 ± 0.15) s, 94.9% ± 3.41%, and (0.91 ± 0.05) cm respectively. The HmaxD of the male (2.04 ± 0.46) cm was significantly larger than that of the female (1.78 ± 0.47) cm (t = 2.44, P = 0.017), but the PTT, PCR, and EEmax had no significant difference between different gender and age groups (P > 0.05).

CONCLUSIONSObjective parameters of the HmaxD, PTT, PCR, and EEmax during swallowing are obtained in Chinese adults. These data are important for assessment of the swallow function and these data provide a foundation for further research on assessment of swallowing function in Chinese.

Adult ; Deglutition ; physiology ; Female ; Healthy Volunteers ; Humans ; Larynx ; physiology ; Male ; Middle Aged ; Pharynx ; physiology ; Reference Values ; Young Adult

OBJECTIVEThe purpose of the present study was to identify the relationship between the plasma level of adiponectin and in-stent restenosis of patients with coronary heart disease after coronary stenting.

METHODThe study population comprised 119 individuals (92 men) who underwent stent implantation, including 65 subjects without in-stent restenosis (group A) and 54 patients with in-stent restenosis (group B). The level of plasma adiponectin was measured using ELISA. Coronary angiography was performed immediately before and after implanting stent and 9 - 12 months later.

RESULTSBaseline characteristics including drug use after PCI were similar between the groups. The rate of implanting bare metal stent is 8 (12.31%) and 6 (11.11%), TAXUS drug-eluting stent is 11 (16.92%) and 10 (18.52%) and CYPHER drug-eluting stent is 46 (70.77%) and 38 (70.37%) respectively (all P > 0.05). Plasma level of adiponectin in patient of group A was significantly higher than that in group B [(15.16 +/- 5.02) mg/L vs. (10.01 +/- 4.93) mg/L, P < 0.05]. The quantitative coronary angiography (QCA) showed that lesion length was similar between groups [(15.82 +/- 6.67) mm vs. (13.40 +/- 4.20) mm, P > 0.05], minimum lumen diameter (MLD) and stenosis rate were also similar before and after implanting stent (P > 0.05) and acute gain was (1.48 +/- 0.65) mm vs. (1.19 +/- 0.37) mm (P > 0.05). MLD was higher in group A than that in group B [(2.55 +/- 0.53) mm vs. (0.57 +/- 0.60) mm, P < 0.01] at 9 - 12 months follow up. Restenosis rate [(24.2 +/- 11.2)% vs.(81.0 +/- 19.1)%, P < 0.01] and late lumen loss [(0.50 +/- 0.34) mm vs. (1.60 +/- 0.54) mm, P < 0.01] were lower in group A than in group B.

CONCLUSIONSThe lower plasma adiponectin level might be associated with in-stent restenosis after coronary stenting.

Adiponectin ; blood ; Adult ; Aged ; Coronary Restenosis ; blood ; pathology ; Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome