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

Objective To design a speech voice sample text with all phonemes in Mandarin for subjective auditory perceptual evaluation of voice disorders. Methods The principles for design of a speech voice sample text are: The short text should include the 21 initials and 39 finals, this may cover all the phonemes in Mandarin. Also, the short text should have some meanings. Results A short text was made out. It had 155 Chinese words, and included 21 initials and 38 finals (the final, (e), was not included because it was rarely used in Mandarin). Also, the text covered 17 light tones and one "Erhua". The constituent ratios of the initials and finals presented in this short text were statistically similar as those in Mandarin according to the method of similarity of the sample and population( r =0. 742, P ＜0. 001 and r =0.844, P ＜ 0.001, respectively). The constituent ratios of the tones presented in this short text were statistically not similar as those in Mandarin(r = 0. 731, P ＞ 0. 05 ). Conclusions A speech voice sample text with all phonemes in Mandarin was made out. The constituent ratios of the initials and finals presented in this short text are similar as those in Mandarin. Its value for subjective auditory perceptual evaluation of voice disorders need further study.

Objective To explore the relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and hypertension.Methods There were 1149 middle aged patients who were suspected to have OSAHS underwent polysomnography (PSG) from Jan,1999 to June,2011.The age of the patients ranged from 45 to 65 years. The patients were divided into 10 groups according to sleep apnea hypopnea index (AHI),group 1:AHI ＜5; group 2:5≤AHI ＜ 15; group 3:15≤AHI ＜30; group 4:30≤AHI ＜40 ; group 5:40 ≤ AHI ＜ 50 ; group 6:50 ≤ AHI ＜ 60 ; group 7:60 ≤ AHI ＜ 70 ; group 8:70 ≤ AHI ＜ 80 ;group 9:80 ≤ AHI ＜ 90; group 10:AHI ≥90.The incidence of hypertension in each group was tested using crosstabs method.The correlation between AHI,lowest oxygen saturation (LSaO2 ),age,body mass index (BMI) and hypertension were analyzed.Results Among 1149 suspected OSAHS patients,1004 were diagnosed as OSAHS by PSG.There were positive correlation between AHI and diastolic,systolic blood pressure ( r were 0.239 and 0.305,respectively,P ＜ 0.01 ). AHI was independent risk factor of hypertension(P ＜0.001 ).No statistically significant difference in the incidence of hypertension was found among group 1 and group 2,3,group 4 and group 5,group 6 to group 10 ( x2 were 3.821,0.005 and 1.325,P ＞ 0.05,respectively).There was significant difference in the incidence of hypertension among group 4 and group 1,2,3,group 5 and group 6 ( x2 were 2.615 and 4.300,P ＜0.05,respectively).There were two cutoff points at the AHI of 30 and 50.Conclusion With OSAHS exacerbations,the incidence of hypertension was significantly increased.

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

Objective To evaluate the value of electronic laryngoscope for transnasalesophagoscopy.Methods The electronic laryngoscope was used for transnasal esophagoscopy in 50 patientsfrom June 2009 to June 2011.There were 32 males and 18 females with their age ranged from 16 -88 years (mean 53.8 years).Before esophagoscopy,1％ ephedrine-dicaine mixture was sprayed into the nasal and pharyngeal cavities for topical anesthesia.The esophagoscopy was used for screening examination in the patients with reflux,globus sensation,dysphagia,head and neck cancer,suspected foreign body,and vocal cord paralysis,etc.Results The transnasal esophagoscopy with electronic laryngoscope was performed successfully in all the patients.Mild nausea and vomiting occurred in 4 patients,but no patient required to stop the examination.Of the 50 patients,38 patients (76％) had normal findings and 12 patients (24％)had positive findings of the esophagus.Esophageal cancer was diagnosed in one patient,esophageal foreign body in 2 patients,esophageal injury in one patient,candidal esophagitis in 3 patients,esophagitis in 3 patients,and achalasia of the cardia in 2 patients.Conclusions The electronic laryngoscope for transnasal esophagoscopy is an alternative to conventional esophagoscopy,which is useful for screening the esophagus in the patients with reflux,globus,dysphagia,head and neck cancer,and suspected foreign body,etc.

Objective To observe the habituation of seasickness in non marine subjects during a long voyage.Methods A 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.Results The 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％ ) ( x2 =7.161,P =0.007 ).Conclusions The 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.

Objective To investigate the reliability and validity of the simplified Chinese version of Epworth sleepiness scale(ESS). Methods Five hundred and eighty-five patients with suspected obstructive sleep apnea hypopnea syndrome (OSAHS) and 103 OSAHS patients who underwent operations were included in this study. The ESS was filled before polysomnography (PSG) monitoring under the direction of professional technicians. The patients who underwent operations did both PSG and ESS tests more than 6 months after operation. Fifty-one patients who underwent PSG at our hospital from July to August, 2010 were chosen to assess the ESS test-retest reliability on two separate occasions at least more than one week. Results The total Cronbach's Alpha of ESS was 0. 814. The test-retest reliability of ESS total scores was 0.679 and for each item was from 0.473 to 0.698 ( P ＜ 0.01 ). Split-half reliability was 0.817 ( P ＜ 0.01 ). In the analysis of discriminant validity with apnea hypopnea index (AHI), the ESS total scores and each item's scores had significant differences in severity in OSAHS patients and simple snoring patients( P ＜ 0.05 ), and this was also true in different degrees of lowest saturation of arterial oxygen ( LSaO2 ) patients and normal LSaO2 patients(P＜0.05). The factor analysis of construct validity showed that 4 factors were extracted.The cumulative proportion was 74.270%. The loading was higher than 0. 4 among every item. The correlation coefficiency of overall ESS scores and each item's scores was relatively high except the last item.The ESS had low consistency with clinical diagnosis(κ =0.099,P ＜0.01 ) and the predictive validity was not good (r =0.138, P ＜0.01 ). As for 103 patients who had operations, the initial assessment of total ESS scores were 15.0[10;20] ( M[P25 ;P75] ) ,and improved to 4[1 ;6] after operation. The patients who got effective results had significant difference in the total ESS scores before and after operation ( Z = - 7.528,P＜0.01) ,so was the patients who got ineffective results(Z= -4.382, P＜0.01) . Conclusions The simplified Chinese version of ESS had a good reliability and validity. It can be used to evaluate the chance of dozing in the daytime.

Objective The consistency of reflux finding score (RFS) was studied by three different level of throat physicians.Methods One hundred and ten laryngeal photos were chosen to assess the RFS test-retest reliability on two separate occasions at least more than one week.Results The 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 testretest 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 (x2 =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％ (K=0.617,P=0.000),A with C was 85.5％ (K =0.644,P =0.000),B with C was 89.1％ (K=0.720,P =0.000).The intraobserver consistency was 91.8％ (K =0.807,P =0.000),81.8％ (K =0.534,P =0.000),90.9％ (K =0.741,P =0.000) respectively.Conclusions The 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.