Since the anatomy of vocal fold and physiology of phonation are introduced, many surgical techniques for vocal fold disorders has advanced. Microflap and mini-microflap surgery were designed to protect the bare surface of the operated site. However, many new techniques have been based on common sense because of the absence of an accessible animal model with a vocal ligament. Therefore, authors studied to evaluate the differences of the results between mini-microflap surgery and microdissection surgery. Thirty-four mini-microflap surgeries(17 bilateral) and twenty-eight microdissection surgeries(14 bilateral) were performed on 31 patients. Patients' subjective evaluation and videostrobolaryngoscopic examination revealed that mini-microflap surgery was better than microdissection surgery. A mini-microflap surgery, as does limited mucosal resection, was more efficacious in the treatment of vocal nodules than microdissection surgery.
Humans ; Microdissection* ; Models, Animal ; Phonation ; Physiology ; Vocal Cords

Thyroarytenoid(TA), lateral cricoarytenoid(LCA), and IA muscles are referred to as the adductors of the vocal fold. The TA is known to shorten the vocal folds and to adduct the membranous vocal fold, and the LCA adducts the inter-vocal process region and IA adducts the posterior commissure. Even though IA has an important role for the positioning of the vocal folds during respiration and phonation together with the action of the posterior cricoarytenoid muscle, little is known about the effect of IA on voice parameters during phonation. An in vivo canine model was used in five mongrel dogs to examine the role of the IA muscle in controlling phonation. In two out of five dogs, sound could not be elicited without stimulating the IA branches of the recurrent laryngeal nerves. When the IA was dynamically and statistically stimulated, subglottic pressure, vocal intensity and fundamental frequency were increased. However, open quotient was not changed markedly. These results suggest that the IA affects the voice parameters mainly by controlling subglottic pressure during phonation.
Animal ; Dogs ; Electric Stimulation ; Laryngeal Muscles/*physiology ; Laryngoscopy ; Models, Biological ; Phonation/*physiology ; Videotape Recording

Ultrasonography has increasingly moved from being a modality confined to the radiology department to an active diagnostic and therapeutic aid available to the head and neck at the point of patient care. However, the application of ultrasonography to the laryngeal disorder is very rare due to progressive age-related ossification of laryngeal cartilage and the presence of air in the lumen, which contribute to difficult conditions for transmission of the ultrasonic waves. The observation about the movements of larynx or surrounding structures is important to understand the physiology of phonation or swallowing and to diagnose the disease. Ultrasonography is a noninvasive and safe imaging technique that can be used to investigate the anatomic structures of the head and neck. Recently, the development of high-frequency ultrasonography makes it possible to apply the ultrasound in the evaluation of larynx.
Deglutition ; Diagnosis ; Head ; Laryngeal Cartilages ; Larynx ; Neck ; Patient Care ; Phonation ; Physiology ; Ultrasonic Waves ; Ultrasonography

BACKGROUND AND OBJECTIVES: The two most important methods for voice rehabilitation after total laryngectomy are tracheoesophageal speech and esophageal speech. The former can be obtained in several ways, for example, by the primary Amatsu tracheoesophageal (T-E) shunt operation or by the use of a low-resistance valve such as the Provox prosthesis. The purpose of this investigation was to study the anatomy and physiology of the neoglottis and to evaluate the vocal quality of tracheoesophageal speech. MATERIALS AND METHODS: A total of 12 patients, who had undergone the Amatsu T-E shunt operation after total laryngectomy, were analyzed using the stroboscopy, laryngofiberscopy, videofluoroscopy, and computerized speech lab. RESULTS: With stroboscopy, the neoglottis was split from left to right in 3 patients and in 9 patients, the direction of opening and closure of rheeoglottis was anterior-posterior. The regular vibratory features were observed in patients with a shortened visible vibratorvsegment. The results of videofluoroscopy indicate that the location of the vibration was mostly situated between C3 and C5. The cervical esophagus closure during tracheoesophageal phonation was located at a level between C7-T2. CONCLUSION: The anatomical and morphological characteristics of the neoglottis was related to the healing process after operation. The neoglottis was considered to be formed by the thyropharyngeal muscle, and concentric contraction under subneoglottic extension was formed by the contraction of the cervical esophagus.
Acoustics* ; Esophagus ; Humans ; Laryngectomy ; Phonation ; Physiology ; Prostheses and Implants ; Rehabilitation ; Speech, Esophageal ; Stroboscopy ; Vibration ; Voice

OBJECTIVE: To study the spontaneous rehabilitation and phonation quality of vocal cords after different types of CO2 laser microsurgery. METHOD: Surgical procedures based on Remacle system Type I, Type II, Type III, Type IV and Type V a respectively. Three hundred and fifteen cases with hoarseness based on strobe laryngoscopy results were prospectively assigned to different group according to vocal lesions apperence,vocal vibration and imaging of larynx CT/MRI. Each group holded 63 cases. The investigation included the vocal cords morphological features,the patients' subjective feelings and objective results of vocal cords. RESULT: There are no severe complications for all patients in perioperative period. Vocal scar found in Type I ,1 case; Type II, 9 cases ;Type III, 47 cases; Type IV, 61 cases and Type Va 63 cases respectively after surgery. The difference of Vocal scar formation after surgery between surgical procedures are statistical significance (χ2 = 222.24, P < 0.05). Hoarseness improved after the surgery in 59 cases of Type I , 51 cases of Type II, 43 cases of Type III, 21 cases of Type IV and 17 cases of Type Va. There are statistically significance (χ2 = 89.46, P < 0.05) between different surgical procedures. The parameters of strobe laryngoscope: there are statistical significance on jitter between procedures (F 44.51, P < 0.05), but without difference within Type I and Type II (P > 0.05). This happened in shimmer parameter and the maximum phonation time (MPT) as jitter. There are no statistical significance between Type IV and Type Va on MPT (P > 0.05). CONCLUSION Morphological and functional rehabilitation of vocal cord will be affected obviously when the body layer is injured. The depth and range of the CO2 laser microsurgery are the key factors affecting the vocal rehabilitation.
Cicatrix ; Hoarseness ; therapy ; Humans ; Laryngoscopes ; Laryngoscopy ; Laser Therapy ; Lasers, Gas ; Microsurgery ; Phonation ; Vocal Cords ; physiology ; surgery

BACKGROUND AND OBJECTIVES: The observation about the movements of laryngopharyngeal or surrounding structures is very important to understand the physiology of phonation or swallowing and to diagnose the disease. Many investigating methods were used but most of them were ineffective because those were invasive or indirect methods. Ultrasonographical examination of larynx can be applied, but the shortcomings of mechanics limits the usage of ultrasonographical study of larynx. Recently, the revolution of computer and videosystem made ultrasonographical study to be applied to the larynx. In this study, authors wanted to find out the availability of the ultrasonographical study of larynx. MATERIALS AND METHODS: 3.5 and 7.5 MHz probes were applied to anterior neck and the ultrasonographical findings were observed according to the various phonation types. RESULTS: In the axial plane, the movements of bilateral vocal folds were observed. Unilateral movement of vocal cord alone was seen in the case of unilateral vocal cord paralysis. In the parasagittal plane, the movements of whole laryngopharyngeal structures were observed simultaneously. A specific tongue shape was seen on each vowel phonation. On phonation with high pitch, hyoid bone and thyroid cartilage were elevated. And thyroid cartilage was elevated and laid upon the hyoid bone moving medially. On phonation with high pitch extremely, the hyoid bone went down. On phonation loudly, echogenicity of surrounding muscles was increased. CONCLUSION: Authors think that the ultrasonographical study can be applied to the physiologic study of phonation as well as diagnostic tools or therapeutic tools.
Deglutition ; Hyoid Bone ; Larynx* ; Mechanics ; Muscles ; Neck ; Phonation ; Physiology ; Thyroid Cartilage ; Tongue ; Ultrasonography ; Vocal Cord Paralysis ; Vocal Cords

OBJECTIVETo investigate the application and significance of aerodynamic parameters in voice function assessment.

METHODSThe phonatory aerodynamic system (PAS) was used to collect aerodynamic parameters from subjects with normal voice, vocal fold polyp, vocal fold cyst, and vocal fold immobility. Multivariate statistical analysis was used to compare measurements across groups.

RESULTSPhonation threshold flow (PTF), mean flow rate (MFR), maximum phonation time (MPT), and glottal resistance (GR) in one hundred normal subjects were significantly affected by sex (P < 0.05), while phonation threshold pressure (PTP), subglottal pressure (SGP), and vocal efficiency (VE) were not (P > 0.05). PTP, PTF, MFR, SGP, and MPT were significantly different between normal voice and voice disorders (P < 0.01), and there were no significant differences among the three disorders (P > 0.05). Receiver operating characteristic (ROC) analysis found that PTP, PTF, SGP, MFR, MPT, and VE in one hundred thirteen voice dis orders had similar diagnostic utility (P < 0.01), with PTP exhibiting the highest area under the curve. The aerodynamic parameters of the three degrees of voice dysfunction due to vocal cord polyps were compared and found to have no significant differences (P > 0.05). PTP, PTF, MFR, SGP and MPT in forty one patients with vocal polyps were significantly different after surgical resection of vocal cord polyps (P < 0.01).

CONCLUSIONThe aerodynamic parameters can objectively and effectively evaluate the variations of vocal function, and have good auxiliary diagnostic value.

Adolescent ; Adult ; Female ; Glottis ; physiology ; Humans ; Laryngeal Diseases ; diagnosis ; physiopathology ; Male ; Middle Aged ; Multivariate Analysis ; Phonation ; physiology ; Polyps ; diagnosis ; physiopathology ; Vocal Cords ; physiology ; Voice Disorders ; diagnosis ; physiopathology ; Voice Quality ; Young Adult