Objective:To investigate the efficacy of type I thyroplasty with Montgomery prosthesis implantation for the treatment of unilateral vocal fold paralysis.Methods:From May 2015 to March 2019, 46 patients (24 males, 22 females, with age range of 23-77) with unilateral vocal fold paralysis underwent thyroplasty with Montgomery prosthesis implantation in the Department of Otorhinolaryngology Head and Neck Surgery in both the First Affiliated Hospital of Navy Medical University and Guangdong Provincial People’s Hospital. The assessment methods included GRBAS auditory perception assessment, acoustic analysis such as Jitter, Shimmer, NHR and maximum phonation time (MPT).Results:Postoperative videostroboscopy observed the displacement of paralyzed vocal fold to the midline in 44 cases as well as significantly reduced glottic fissures during phonation. In the other 2 cases, glottic fissure did not reduce significantly. Compared with preoperative data, the scores of all parameters in GRBAS auditory perception assessment were lower except the parameter S, and the acoustic analysis parameters (jitter, shimmer, NHR) were smaller, and MPT was longer. All the difference was statistically significant ( P<0.001). Revision surgery was performed in 2 patients with poor results. No serious complications occurred in all the cases. Conclusions:For the patients with unilateral vocal fold paralysis who are not suitable for the laryngeal reinnervation surgery due to old age or long course of denervation, thyroplasty with Montgomery prosthesis implantation can effectively improve the voice of patients with high safety,which is worthy of promotion.

Objective To investigate the correlation between the indications,findings,interventions of fibrobronchoscopy(FB) in neonates and their correlative diseases with neonatal FB results and clinical data.Methods Retrospective case series of 243 consecutive patients of 28 days old or younger were investigated underwent FB for the first time from January 2010 to December 2014,at a tertiary care hospital.The common indications for FB and detection rate of respiratory tract diseases were collected.If the findings of FB had significant associations with premature birth and other diseases were analyzed.Associations between interventions and basic illnesses were also analyzed.Results Of the 243 patients undergoing 275 procedures of FB,201 cases were boys(73.1％).The age of FB was (13.34 ± 9.76) days and the weight was (3.08 ± 0.68) kg.Forty-five cases were premature infants (16.4％).A total of 254 procedures were found to have congenital diseases (92.4％),and 177 cases of them had congenital heart diseases (CHD) (64.4％).Common indications for FB were dyspnea(140 cases,50.9％),tachypnea(82 cases,29.8％),and stridor(71 cases,25.8％).A total of 188 upper airway lesions were found and the most common findings were laryngomalacia(56 cases,20.4％) and vocal cord paralysis(bilateral/unilateral,50 cases,18.2％).A total of 315 lower airway lesions were found and the most common findings were airway mucosal inflammation (98 cases,35.6％),trachea and main bronchial stenosis (73 cases,26.5 ％).A total of 21 cases (7.6％) underwent supraglottoplasty during or after FB,while 17 cases (6.2％) underwent tracheal dilation and 10 cases (3.6％) underwent tracheotomy.Compared with non-CHD neonates,neonates with CHD were statistically significantly less likely to have congenital lesions statistically,such as laryngomalacia(15.8％ vs.28.6％,P =0.012),bilateral vocal cord lesions(6.2％ vs.21.4％,P =0.000) and congenital laryngeal dysplasia(0 vs.7.1％,P =0.001).The tracheotomy(0 vs.10.2％,P =0.000) and supraglottoplasty(2.3％ vs.17.3％,P =0.000) were more rare.Nevertheless,they were more likely to have secondary lesions such as the left main bronchial stenosis caused by extrinsic compression (23.7％ vs.1.0％,P =0.000),abnormal bronchial anatomy(9.6％ vs.2.0％,P =0.018),left vocal cord paralysis(9.0％ vs.1.0％,P =0.008) and airway mucosal inflammation(41.8％ vs.24.5％,P =0.004).The tracheostenosis and main broncial stenosis (37.3％ vs.7.1％,P =0.000) with long-term intubation(78.5％ vs.58.2％,P =0.000) were more common.There was no significant difference between term neonates and premature infants in the detection rate of respiratory tract diseases (P ＞ 0.05),tracheotomy (0 vs.4.3 ％,P =0.322),supraglottoplasty (13.3 ％ vs.6.5 ％,P =0.205) or long-term i ntubation (80.0％ vs.69.6％,P =0.157).Complications caused by procedure were rare and mild.Conclusions FB can detect whether the neonates with dyspnea,tachypnea and stridor have laryngomalacia,vocal cord paralysis,airway mucous edema,tracheal and main bronchial stenosis and other signs,and FB may play an important role in diagnosis,treatment and prognosis evaluation of neonatal respiratory diseases.

OBJECTIVE: To understand the vowel duration and statement reading of the adductor spasmodic dysphonia (ADSD) patients compared with their normal controls, and provide ideas for clinical diagnosis and treatment. METHOD: Twenty-nine ADSD patients were included in the research, with 31 normal controls. All subjects filled in form voice handicap index (VHI) by themselves. Maximum phonetic time (MPT) and maximum loudness phonetic time(MLPT) were tested on /a/ sound for all patients. Also, all the patients were required to read aloud a standard mandarin assay named , duration were measured with Praat5. 0 software after sounds were collected. A one-way t-test was performed to compare spasmodic group with control group on VHI, MPT, MLPT and duration for reading standard sentences. Pearson/Spearman correlation was tested. Result: The VHI of the 29 ADSD patients is 89±12, and their normal controls 15±16, indicating that the VHI in ADSD group is significantly higher than in the control group(P<0. 01). The MPT of the ADSD group is(16. 9±9. 8 s), and the control group is (25. 3±10.0)s, indicating that MPT in the ADSD group is significantly shorter than the control group(P<0. 01). The MLPT of the ADSD group is (15.7±7. 6)s, and the control group is (26. 5±11. 4)s, indicating that MLPT in the ADSD group is significantly shorter than the control group (P<0. 01). The duration of standard sentence reading of the ADSD group is (55.0±14. 2)s, and the control group is (37. 8±4. 8)s, indicating that the duration of standard sentence reading in the ADSD group is significantly longer than the control group (P<0. 01). Correlation analysis showed that MPT and MLPT are related within the ADSD group(r=0. 697,P< 0.01), other indexes being tested have no significant correlations. CONCLUSION The voice disorder condition of the ADSD patients is significantly worse than normal people. Their pronunciations on continuous vowels are not lasting compared with normal people. In the meantime, their ability to read sentences is worse than normal people, needing longer time to complete the reading task. There is a significant correlation between MLPT and MPT, which can be used as an alternative to MPT.
Case-Control Studies ; Dysphonia ; diagnosis ; Humans ; Phonetics ; Voice Quality

Objective To investigate the effect of voice training therapy on the voice improvement in patients with vocal nodules .Methods Twenty one patients with vocal nodules were recruited and were evaluated by the GRBAS perpetual evaluation ,voice handicap index (VHI)-30 subjective assessment ,vocal laryngostroboscopy , maximum phonation time (MPT) and acoustic analysis pre- and post-therapy .These patients completed 5 cour‐ses of voice training .Results The VHI value(29 .48 ± 21 .21) of post-therapy was less than the value (52 .95 ± 24 . 30)of pre -therapy (P< 0 .01) .There were significantly differences in voice perpetual evaluation between pre -training and post-training ,especially for G (grade) (P<0 .01) and R (roughness) (P<0 .01) .The post-training laryngostrobescopy vocal vibration improved comparing with pre-therapy in the closure of vocal cords ,symmetry of vibration ,the mucosal wave and vibration regularity of the vocal cords .After therapy ,three patient nodules dis‐appeared ,thirteen patient nodules became smaller ,and five patient nodules remained the same .The maximum pho‐nation time (MPT) (12 .54 ± 3 .68)of post-therapy was longer than MPT(8 .87 ± 3 .75) of pre-therapy MPT(P<0 .01) .The jitter value (0 .18% ± 0 .08% ) of post -therapy was less than that of pre-therapy(0 .43% ± 0 .31% ) (P<0 .01) .The shimmer of post -therapy (2 .10% ± 0 .98% ) was less than that of pre -therapy (4 .55% ± 1 .80% )(P<0 .01) ,The ratio of noise to harmonic(NHR)(0 .0034 ± 0 .0022 dB) of post-therapy was significantly less than NHR(0 .0184 ± 0 .028 dB)(P<0 .05) of pre-therapy .Conclusion The voice therapy could significantlyimprove voice of patients with vocal nodules .

OBJECTIVE: To investigate the characteristics of adductor spasmodic dysphonia phonatory break in mandarin Chinese and select the stimuli phrases. METHOD: Thirty-eight patients with adductor spasmodic dysphonia were involved in this study. Standard phrase " fù mŭ xīn" and a speech corpus in mandarin Chinese with 229 syllables covering all vowel and constant of mandarin Chinese were selected. Every patient read the phrases above twice in normal speed and comfortable voice. Two auditory perpetual speech pathologists marked phonatory break syllables respectively. The frequency of phonatory break syllables and their located phrases were calculated, rated and described. The phrases including the most phonatory break syllables were selected as stimuli phrases, the phonatory break frequency of which was also higher than that of standard phrase "fù mŭ xīn". RESULT: Phonatory break happened in the reading of all patients. The average number of phonatory break syllables was 14 (3-33). Phonatroy break occurred when saying 177 (77.3%) syllables in the speech corpus. The syllables "guŏ, rén, zāng, diàn, chē, gè, guăn, a, bā, ne, de" broke in 23.1%-41.0% patients. These syllables belonged to the phrases "pĭng guŏ, huŏ chē, shì de, nĭ shì gè hăo rén, wŏ mén shì yŏu zŏng shì bă qĭn shì nong dé hĕn zāng, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a,wŏ yīng gāi zài xìn lĭ xiĕ yī xiē shén mē ne?". Thirty-seven patients (97.3%) had phonatory break in above mentioned words. Ratios of these words phonatory break also were more than "fù mŭ xīn". CONCLUSION Adductor spasmodic dysphonic patients exhibited different degrees of phonatory break in mandarine Chinese. The phrases" shì de, pĭng guŏ, huŏ chē, nĭ shì gè hăo rén, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a" were recommended as stimuli phrases for adductor spasmodic dysphonia evaluation.
Dysphonia ; diagnosis ; physiopathology ; Female ; Humans ; Language ; Male ; Phonation ; Spasm ; diagnosis ; physiopathology ; Voice

OBJECTIVE: To investigate the clinical treatment effect of refractory hypertension accompanied with OSAHS by surgery on upper airway. METHOD: Thirty-two patients were enrolled in our research. PSG and blood pressure were examined on preoperation and 6th month, 1 year, 2 year of postoperation. RESULT: The AHI and the time of SaO2 < 90% were lower significantly, and LSaO2 was improved (P < 0.01). The blood pressures of 32 patients were decreased. CONCLUSION The operation on upper airway could improve the hypertension of patient with OSAHS effectively.
Adult ; Blood Pressure ; Female ; Humans ; Hypertension ; surgery ; Male ; Respiratory System ; surgery ; Sleep Apnea, Obstructive ; surgery

OBJECTIVE: To study surgical techniques and clinical applications of the intranasal endoscopic combined approach in maxillary sinus benign lesions surgery. METHOD: A retrospective clinical analysis of 27 patients "whose unilateral maxillary sinus benign lesions operated by the intranasal endoscopic middle meatus with inferior meatus tears recess approach surgical treatment was studied. RESULT: Benign lesions were confirmed by pathology in all patients before and after surgery as to rule out malignancy. All patients had been followed up for 12 to 24 months. Twenty-seven cases resulted in normal luminal epithelium and inferior turbinate shape after surgery. Only one case of papilloma relapsed 2 months after operation. So far, the papilloma has not recurred after the second surgery. There were no epiphora in all cases. CONCLUSION Endonasal endoscopic expand anterior tears recess approach have great and clear view. This approach made us accurately, mini-invade and completely remove the maxillary sinus benign lesions. It is a physiological and functional surgery and has great advantage in the nasal cavity disease treatment.
Adult ; Aged ; Endoscopy ; methods ; Female ; Humans ; Lacrimal Apparatus ; surgery ; Male ; Maxillary Sinus ; Middle Aged ; Nasal Surgical Procedures ; methods ; Nose ; surgery ; Paranasal Sinus Diseases ; surgery ; Retrospective Studies

The voice is a complex multidimensional phenomenon. It is a drive through the lung airflow to vibrate the vocal cords, and then be perceived by the listeners. A multidimensional set of minimal basic measurements suitable for the voice diseases are proposed by the Committee on Phoniatrics of the European Laryngological Society in 2000. It includes five different aspects: the subjective physician perception (grade, roughness, breathiness), and subjective rating by the patient, videostroboscopy (closure, regularity, mucosal wave and symmetry), acoustics analysis and aerodynamics measurements. The first three are the subjective assessment of voice, these are not to be discussed in tis article. Only objective assessments of the voice and the latest research progress are summarized below.
Acoustics ; Humans ; Vocal Cords ; Voice Quality

OBJECTIVE: To use the maximum loudest phonation time (MLPT) on evaluation of unilateral vocal fold paralysis. METHOD: The MLPT, maximum comfortable phonation time (MCPT) and maximum phonation time (MPT) were tested and collected in 17 patients with unilateral vocal fold paralysis. The data of ratio value of MLPT to MCPT also was collected. The stroboscopy, perceptual measures and self-questionnaire also were used in evaluation of vocal fold and voice in all patients. Correlation coefficients were used as measures of agreement. RESULT: MLPT was (5.0 +/- 4.0)s, MCPT was (5.4 +/- 4.1)s, and MPT was (6.1 +/- 4.5)s in patients. The MPT was composed of MLPT in 4 patients and MCPT in 13 patients. The MLPT/MCPTa was 1.08 +/- 0.47. MLPT was positively correlated with MCPT and MPT, respectively (r = 0.679, P < 0.01; r = 0.878, P < 0.01), and MCPT also was positively correlated with MPT (r = 0.993, P < 0.01). MLPT, MCPT and MPT was negatively correlated with G value which was from GRBAS scale, respectively (r = -0.620, P < 0.05; r = -0.564, P < 0.05; r = -0.665, P < 0.05). The MLPT/MCPTa was positively correlated with the value of question 4 from self-questionnaire (r = 0.534, P < 0.05). MLPT, MCPT or MPT had no correlation with self-questionnaire, GRBAS perceptual evaluation or stroboscopy measures significantly. CONCLUSION MLPT, MCPT or MPT can be used for evaluation of aerodynamic measures in unilateral vocal fold paralysis. The MLPT may be easiest to operate in clinic. The MLPT/MCPTa ratio can assess dysphagia in unilateral vocal fold paralysis patients.
Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Phonation ; Vocal Cord Paralysis ; pathology ; physiopathology ; Vocal Cords ; pathology ; Voice Quality ; Young Adult

OBJECTIVE: To study the mRNA expression of muscle phenotype and collagen of soft palate and pathology in obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD: We used the Real-time PCR to test the mRNA expression of soft palate muscle myosin heavy chain (MyHC) phenotype and collagen in 12 OSAHS patients and 8 control patients. We also distinguished the muscle isoforms I , II with ATPase staining, then counted the numbers of isoforms muscle fiber. RESULT: The mRNA expression of OSAHS group was more than control group in II A MyHC phenotype (P<0.01). The number of OSAHS group muscle fibre I isoform was less than control group with pH4. 3 ATPase staining (P<0.05). CONCLUSION Compare to control group, the enhancement happened in the mRNA expression of II A MyHC phenotype which can increase the velocity and power but de crease the enduring quality of muscle in OSAHS, and the reduce be in the I MyHC isoform of muscle fiber that can cause muscle velocity become slower and persistency become longer in OSAHS patients.
Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Muscle Fibers, Skeletal ; metabolism ; pathology ; Myosin Heavy Chains ; metabolism ; Palate, Soft ; metabolism ; pathology ; Phenotype ; Protein Isoforms ; metabolism ; RNA, Messenger ; genetics ; Sleep Apnea, Obstructive ; metabolism ; pathology