Using simultaneous photodetection and nasometry to monitor velopharyngeal behavior during speech

The purposes of this investigation were (a) to study the temporal relationships among velopharyngeal closing and opening maneuvers monitored by phototransduction and the onset and offset of Nasometer output signals and (b) to determine the extent to which photodetector output maxima are correlated with output peaks from the Nasometer when both are used simultaneously to monitor nasal productions among normal speakers. Simultaneous Nasometer and photodetector data were collected from 6 normal adult subjects as they produced 6 repetitions of 10 sentences. A major finding of this study was that over 96% of the 540 nasal utterances studied produced Nasometer and photodetector signal maxima that were within 30 ms of one another. The results of this study also suggest that simultaneous nasometry and photodetection may provide useful information concerning the temporal relationships among various velopharyngeal movements and the onset and offset of speech as indicated by output signals from the Nasometer. The potential use of this procedure with clinical patients is discussed.     

A fundamental study of rhinomanometry and its clinical application to objective evaluation

We measured differential pressure and airflow at constant flow through a cylinder which had a variable aperture in its central portion, by means of a Rhinorheograph MPR-1100 in order to obtain a turbulent coefficient "n" experimentally in the equation R = delta P/Vn. Between of 1.0-5.0 cm H2O (not equal to 100-500 Pa) pressure, the coefficient "n" was distributed between 1.01-2.80 with a mean value of 2.02 (+/- 0.36), and resistances calculated from the equation R = delta P/Vn were almost the same value at each differential pressure. We applied this coefficient to 95 adult patients referred to our nasal airflow laboratory in Toronto, and found the equation R = delta P/V2 to be quite suitable for clinical assessment.     

Using simultaneous nasometry and standard audio recordings to detect the acoustic onsets and offsets of speech

Simultaneously collected nasometric and standard audio recording data were compared to determine the extent to which the acoustic onsets and offsets of speech could be determined from Nasometric signals. Three male and 2 female subjects produced six repetitions of 12 utterances that were initiated and terminated by vowels and consonants of differing phonetic features. The onset of Nasometer output typically followed output from the standard audio recording system by an average of 29 ms (SD = 36.1 ms). A greater temporal discrepancy was observed for signal offsets (mean Nasometer lag = 100 ms; SD = 83.3 ms). Large differences between the two instruments seemed due to differences in their overall sensitivities. The results suggest that the Nasometer may be of limited value in determining the acoustic onsets and offsets of speech. The Nasometer was not designed to sense the acoustic events studied here, and the current results have no bearing whatsoever on the validity of this instrument in providing information concerning nasal resonance.     

First clinical experiences with hormone-therapy of pachydermia laryngis

Summary First clinical experiences with the anti-androgenic drug cyproteroneacetate in treatment of pachydermia laryngis are reported in eleven male and female patients. This endocrine therapy led to complete healing in four and to marked improvement in six patients. One did not respond. Evaluation of the endocrine state of these patients showed imbalance in the androgen/estrogen equilibrium. As the larynx constitutes a secondary sex characteristic and an endocrine target organ, the significance of endocrine factors for pathogenesis and therapy of epithelial changes on the vocal cords is discussed.     

Sign language: its history and contribution to the understanding of the biological nature of language

CONCLUSION: The development of conceptualization of a biological basis of language during the 20th century has come about, in part, through the appreciation of the central nervous system's ability to utilize varied sensory inputs, and particularly vision, to develop language. OBJECTIVE: Sign language has been a part of the linguistic experience from prehistory to the present day. Data suggest that human language may have originated as a visual language and became primarily auditory with the later development of our voice/speech tract. Sign language may be categorized into two types. The first is used by individuals who have auditory/oral language and the signs are used for special situations, such as communication in a monastery in which there is a vow of silence. The second is used by those who do not have access to auditory/oral language, namely the deaf. MATERIAL AND METHODS: The history of the two forms of sign language and the development of the concept of the biological basis of language are reviewed from the fourth century BC to the present day. RESULTS: Sign languages of the deaf have been recognized since at least the fourth century BC. The codification of a monastic sign language occurred in the seventh to eighth centuries AD. Probable synergy between the two forms of sign language occurred in the 16th century. Among other developments, the Abbey de L'Epée introduced, in the 18th century, an oral syntax, French, into a sign language based upon indigenous signs of the deaf and newly created signs. During the 19th century, the concept of a "critical" period for the acquisition of language developed; this was an important stimulus for the exploration of the biological basis of language. The introduction of techniques, e.g. evoked potentials and functional MRI, during the 20th century allowed study of the brain functions associated with language.     

The location of maxillary sinus ostium and its clinical application

The endoscopic sinus surgeons must have a detailed knowledge of inconsistent location of maxillary sinus openings in any interventional maxillary sinus surgeries as it relates to the orbital floor, ethmoid infundibulum and the nasolacrimal duct. Forty cadaver head and neck specimens had been cut sagittally through the nose, such that the lateral nasal wall had been preserved. The findings were documented with an emphasis on location of the maxillary sinus openings. In the present study maxillary sinus ostium opened more commonly into posterior third of the hiatus semilunaris. Accessory maxillary ostium was another variation seen in nearly three-fourths of the cases which opened into membranous meatus inferior to the uncinate process.     

Initial clinical experiences with beta 2-transferrin in oto- and rhinorrhea

We developed tests to measure beta 2-transferrin, and then used this method to investigate the efficiency of beta 2-transferrin in the diagnosis of cerebrospinal fluid rhinorrhea and otorrhea. We also assessed whether the immunochemical method satisfied the five requirements, which are important in the modern investigation of the cerebrospinal fluid (CSF): High rate of accuracy; Wide area of application; Rapid availability; High sensitivity; No risks to the patient. 14 patients known to be suffering from a CSF leakage were investigated with special attention to the above five points. Eight patients had a CSF otorrhea, five a rhinorrhea, and one patient had a post operative CSF leakage from a retroauricular wound. In temporal bone fractures with CSF leakage regular insertion of sterilized foam rubber sponges into the ear allows adequate samples to be collected. In CSF rhinorrhea with profuse leakage there is no difficulty in collecting enough fluid for analysis. If there is too little fluid or if the question of localization arises we insert sterile sponges, as for CSF otorrhea, into the right and the left of the nose as far as the nasopharynx. They are left in place for 6 hours to provide an adequate sample. The analysis of the samples of CSF otorrhea showed a protein content of 3-6 g/l whereas the samples of CSF rhinorrhea, especially from sponges, showed a content of up to 39 g/l.(ABSTRACT TRUNCATED AT 250 WORDS)     

Chemosensitivity of head and neck cancer with the rapid thymidine incorporation assay and its clinical application

Summary The chemosensitivity of various head and neck cancers was investigated with the 5-day rapid thymidine incorporation assay in soft agar culture. The evaluability rate was 56%. Head and neck cancers were sensitive in vitro, in decreasing order, to peplomycin, cisplatin, bleomycin, 5-fluorouracil, mitomycin C, and doxorubicin. Primary tumors and neck metastases exhibited the same sensitivity, with 21% of all specimens tested responding. In vitro chemosensitivities were similar among patients younger than 69 years of age and those older than 70. The predictive accuracy for sensitivity tested prospectively in five cases was 80% and that for resistance in four was 75%. Correspondence to: H. Saito     

人工耳蜗电极设计策略和临床应用

自1984年美国食品药品监督管理局批准第一款人工耳蜗装置用于临床,至今已有30余万听障人群通过人工耳蜗植入走出了无声世界。电极是人工耳蜗装置的核心部件之一,电极设计主要基于耳蜗生理结构和感音原理。不同人工耳蜗公司的电极产品各有其特点,并在临床应用过程中不断改进和完善。人工耳蜗电极植入深度与临床使用效果之间的关系是目前研究的热点,结果尚无定论。随着相关研究的深入和技术的进步,人工耳蜗电极产品将会减小输出频率与螺旋神经节细胞特征频率之间失匹配程度,使患者获得最佳的使用效果。     

Babbling complexity and its relationship to speech and language outcomes in children with cochlear implants.

OBJECTIVE: To investigate if babbling complexity in early childhood is related to speech and language outcomes in later childhood in children with cochlear implants (CIs). STUDY DESIGN: Retrospective. SETTING: Tertiary care hospital. PATIENTS: Nineteen infants with CIs participated. INTERVENTION: Infants received multichannel CIs. MAIN OUTCOME MEASURES: Infant vocal recordings were taken during pre- and post-CI visits up to 13 months post-CI. Vocalizations were measured using a scoring system that takes into account the phonetic complexity of infant vocalizations. Outcome variables included articulation and language measures collected at 4 years of age. Data were analyzed using correlational and regression analyses. RESULTS:: For infants with at least 6 to 9 months of CI experience, the phonetic complexity of babbling is significantly correlated with receptive vocabulary, articulation abilities, and global language skills at 4 years of age. CONCLUSION: The phonetic complexity of prelinguistic vocalizations is related to later speech and language outcomes in children with CIs. This information may be valuable in terms of tracking progress in pediatric CI users.     

Adaptation of the Tinnitus Handicap Inventory into Polish and its testing on a clinical population of tinnitus sufferers

Objective: To describe how the Tinnitus Handicap Inventory (THI) was translated into Polish (THI-POL) and to present psychometric data on how well it performed in a clinical population of tinnitus sufferers. Design: The original version of THI was adapted into Polish. The reliability of THI-POL was investigated using test–retest, Cronbach’s alpha, endorsement rate and item–total correlation. Construct validity and convergent validity were also assessed based on confirmatory factor analysis, inter-item correlation and Pearson product-moment correlations using subscale A (Tinnitus) of the Tinnitus and Hearing Survey (THS-POL); divergent validity was checked using subscale B (Hearing) of THS-POL. Study sample: A group of 167 adults filled in THI-POL twice over their three-day hospitalisation period. Results: Test–retest reliability for the total THI-POL scores was strong (r?=?0.91). Cronbach’s alpha coefficient for the total score was high (r?=?0.95), confirming the questionnaire’s stability. Confirmatory factor analysis (CFA) and inter-item correlation did not confirm the three-factor model. Convergent validity from the Tinnitus subscale of THS showed a positive strong (r?=?0.75) correlation. Divergent validity showed only a moderate correlation. All analyses were statistically significant (p?< 0.01). Conclusions: THI-POL is a valid and reliable self-administered tool, which allows the overall tinnitus handicap of Polish-speaking patients to be effectively assessed.     

A preliminary investigation concerning the use of nasometry in identifying patients with hyponasality and/or nasal airway impairment

A series of 76 patients referred for evaluation at the Oral-Facial and Communicative Disorders Program was studied in an attempt to determine the extent to which acoustic assessments of speech, made utilizing a Kay Elemetrics Nasometer, corresponded with clinical judgments of hyponasality and aerodynamic measurements of nasal cross-sectional area. Among the 38 adults, the sensitivity of Nasometer ratings in correctly identifying adult subjects with moderate to severe nasal airway impairment was 0.38, whereas the specificity was 0.92. Comparable analyses for the group of 38 children were not possible because of the extent to which nasal airway size varies up to the age of 15 years. Among the entire group of patients, the sensitivity and specificity of nasometry in correctly identifying the presence or absence of hyponasality was 0.48 and 0.79, respectively. However, when patients with audible nasal emission were eliminated from analysis, the sensitivity rose to 1.0 and the specificity rose to 0.85. Possible reasons for the findings obtained and their clinical significance are discussed.     

引领聋儿到真实情境中运用语言

聋儿的听力得到适合的补偿或重建之后，通过听觉言语训练来发展语言，提高交往能力。“情境教学”是普遍采用的训练方式之一，它不仅有利于聋儿对语言的理解，也有利于激发聋儿的交往兴趣，形成交往意识，提高交往能力。真实的情境比创设的情境更开放、灵活、有效。