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Αλέξανδρος Γ. Σφακιανάκης

Sunday, August 15, 2021

Prevalence of Laryngopharyngeal Reflux Symptoms, Dysphonia, and Vocal Tract Discomfort in Amateur Choir Singers

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Vocal tract discomfort (VTD), dysphonia, and laryngopharyngeal reflux (LPR) symptoms are complaints frequently reported by amateur singers. There are two aims of this study. The first is to evaluate the prevalence of these symptoms using validated questionnaires. The second is to correlate singing-related variables with the questionnaire responses.
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Vocal Fold Submucosal Mesna Injection and Microflap Elevation in a Rabbit Model

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Mesna triggers chemical dissection in tissues by breaking down disulfide bonds and is used during surgical dissections in several areas. In this study, we aimed to investigate the effect of submucosal mesna infiltration on microflap elevation and the histopathological findings of its effects on the vocal fold lamina propria in a rabbit model.
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Evolution of incidence of audiovestibular disorders during the pandemic COVID-19 period

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Eur Arch Otorhinolaryngol. 2021 Aug 13. doi: 10.1007/s00405-021-07037-4. Online ahead of print.

ABSTRACT

PURPOSE: Despite sporadic case reports describing hearing problems in patients with coronavirus disease 2019 (COVID-19), whether COVID-19 affects the audiovestibular system remains unclear. This study assessed the evolution of incidence of audiovestibular disorders during the pandemic COVID-19 period.

METHOD: Three audiovestibular disorders namely, sudden sensorineural hearing loss (SSHL), autonomic dysfunction, and Meniere's disease (MD) were analyzed and compared from 2016 to 2020.

RESULTS: The annual new cases at our clinic comprised overall 2107, 1997, 1984, 2068, and 1829 from 2016 to 2020, respectively, and the respectively annual cases of SSHL were 54, 46, 42, 45 and 38. Accordingly, annual incidences of SSHL in relation to overall cases of audiovestibular disorders were 2.6%, 2.3%, 2.1%, 2.2% and 2.1% from 2016 t o 2020, respectively, exhibiting a non-significant difference (p > 0.05). In contrast, incidence of autonomic dysfunction in the year 2020 was 15.3%, which revealed significantly higher than 8.5-13.1% from 2016 to 2019 (p < 0.001). Restated, the incidence of autonomic dysfunction in 2020 displayed a significantly higher percentage than the other 4 years. Conversely, the incidence of MD in 2020 was 9.8%, showing a significant decline compared with the other 4 years (12.6-15.6% from 2016 to 2019, p < 0.001), CONCLUSION: Evolution of incidence of audiovestibular disorders during the pandemic COVID-19 period revealed increase in the incidence of autonomic dysfunction and decrease in that of MD, while incidence of SSHL remained unchanged from 2016 to 2020. Thus, the SARS-CoV-2 may less affect the audiovestibular system.

PMID:34389915 | DOI:10.1007/s00405-021-07037-4

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Hydraulic insertions of cochlear implant electrode arrays into the human cadaver cochlea: preliminary findings

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Eur Arch Otorhinolaryngol. 2021 Aug 14. doi: 10.1007/s00405-021-06979-z. Online ahead of print.

ABSTRACT

OBJECTIVES: (1) To evaluate the feasibility of a non-invasive, novel, simple insertion tool to perform automated, slow insertions of cochlear implant electrode arrays (EA) into a human cadaver cochlea; (2) to estimate the handling time required by our tool.

METHODS: Basic science study conducted in an experimental OR. Two previously anonymized human cadaver heads, three commercially available EAs, and our novel insertion tool were used for the experiments. Our tool operates as a hydraulic actuator that delivers an EA at continuous velocities slower than manually feasible.

INTERVENTION(S): the human cadaver heads were prepared with a round-window approach for CI surgery in a standard fashion. Twelve EA insertion trials using our tool involved: non-invasive fixation of the tool to the head; directing the tool to the round window and EA mounting onto the tool; automated EA insertion at approximately 0.1 mm/s driven by hydraulic actuation. Outcome measurement(s): handling time of the tool; post-insertion cone-beam CT scans to provide intracochlear evaluation of the EA insertions.

RESULTS: Our insertion tool successfully inserted an EA into the human cadaver cochlea (n = 12) while being attached to the human cadaver head in a non-invasive fashion. Median time to set up the tool was 8.8 (7.2-9.4) min.

CONCLUSION: The first insertions into the human cochlea using our novel, simple insertion tool were successful without the need for invasive fixation. The tool requires < 10 min to set up, which is clinically acceptable. Future assessment of intracochlear trauma is needed to support its safety profile for clinical translation.

PMID:34390390 | DOI:10.1007/s00405-021-06979-z

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Dynamic analysis for flexion and extension of elbow joint motion based on musculoskeletal model of Anybody

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Abstract

Purpose

Little is known about how biomechanics governs the biological nature for humeral motion dynamically. Elbow motion ought to be investigated based on a musculoskeletal model and evidence the physiologic principle of upper limbs.

Method

A humeral model was reconstructed by MIMICS after CT images input in *.dicom format, it was processed by Geomagic Studio for Surfaces, then gridded mesh and assigned materials by Hypermesh. On the other hand, a musculoskeletal model was built by Anybody, physical motions were then simulated to export boundary condition and myodynamia during flexion and extension. Finally, all the humeral model and boundary were imported to Abaqus for finite element analysis.

Result

During the simulative motion of flexion, the primary muscles are brachii biceps, brachialis anticus and teretipronator, their myodynamia increased and then decreased gradually, and reached its peak value at 30°; During extension, the main muscles are triceps brachii and brachialis anticus, their myodynamia increased and then decreased gradually too, and reached peak at 50°; In these 2 cases, their strain and displacement distributed at the middle of humerus.

Conclusion

AnyBody is a novel modeling system to simulate physical motion, e.g. flexion and extension. Biceps brachii and brachialis anticus are functional for flexion, and triceps brachii plays a key role in extension critically. This simulation confirms the physiologic rule for sport event, humeral fixation and postoperative healing with clinical significance that minimizing joint forces from injury onset may promote pain-free ways.

This article is protected by copyright. All rights reserved.

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Self-Perceived Voice Handicap during COVID19 Compulsory Facemask Use: a Comparative Study Between Portuguese and Spanish speakers

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This study investigates self-perceptions of voice-related handicap, quantified by means of the Voice Handicap Index (VHI), as a function of facemask use in the general working population during the COVID19 outbreak. Each VHI item was answered twice in a raw; the first answer referred to the condition of not wearing a facemask (henceforth, the Without condition) and the second to facemask use (henceforth, the With condition). VHI scores were collected via Google Forms (Google, Mountain View, California), targeting two groups of speakers, Portuguese (n = 261) and Spanish (n = 297).
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Friday, August 13, 2021

Modified Arytenoid Adduction Operation for the Treatment of Unilateral Vocal Fold Paralysis

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Introduction: Unilateral vocal fold paralysis (UVFP) was a relative common glottic insufficiency disease; however, a completely satisfactory treatment of UVFP was elusive. This study was aimed to evaluate the surgical efficacy of modified arytenoid adduction with fenestration of the thyroid cartilage in the management of patients with UVFP, including voice and aspiration outcomes, and to summarize the postoperative complications. Methods: A retrospective analysis was performed on a total of 21 patients who underwent modified arytenoid adduction operation with fenestration of the thyroid cartilage for UVFP from July 2012 to June 2017. The scores of Grade, Roughness, Breathiness, Asthenia, Strain scale (GRBAS), voice self-satisfaction, dynamic laryngoscopy and the voice acoustic data (fundamental frequency [F0], fundamental frequency perturbation [jitter], loudness, amplitude perturbation [shimmer], and maximal phonatory time [MPT], etc.) were statistically analyzed preoperatively and 3–6 months postoperatively. The occurrence of postoperative complications was also summarized. Results: The voice subjective perception of 21 patients was significantly improved after operation. The rate of voice self-satisfaction was 90.5%. The mean values of voice acoustics parameters were significantly improved. The MPT was significantly longer (p #x3c; 0.001), and the ratings of postoperative aspiration were significantly decreased compared with the preoperation. Among the 21 patients, 15 cases had sense of laryngeal obstruction, 8 cases had of 1–2° laryngemphraxis (recovered after 10–15 days). There were 2 cases of laryngeal stridor, 1 case of incision infection, 1 case of pharyngeal fistula, and 1 case of falsetto (corrected by voice training). No patient had laryngeal hematoma, neck hematoma, or laryngospasm. Conclusion: The modified arytenoid adduction operation with fenestration of the thyroid cartilage can significantly improve the vocal function of patients with UVFP and effectively reduce the aspiration, with fewer postoperative complications, less trauma, and more convenient advantages.
ORL
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