Laryngeal motility alteration: A missing link between sleep apnea and vagus nerve stimulation for epilepsy

This study aimed to evaluate the prevalence and the relationship of sleep breathing disorders (SBDs) and laryngeal motility alterations in patients with drug‐resistant epilepsy after vagus nerve stimulator (VNS) implantation. Twenty‐three consecutive patients with medically refractory epilepsy underwent out‐of‐center sleep testing before and after VNS implantation. Eighteen eligible subjects underwent endoscopic laryngeal examination post‐VNS implantation. Statistical analysis was carried out to assess an association between laryngeal motility alterations and the onset/worsening of SBDs. After VNS implantation, 11 patients showed a new‐onset mild/moderate SBD. Half of the patients already affected by obstructive sleep apnea (OSA) showed worsening of SBD. All of the patients with a new‐onset OSA had a laryngeal pattern with left vocal cord adduction (LVCA) during VNS stimulation. The association between VNS‐induced LVCA and SBD was statistically significant. This study suggests an association between VNS and SBD, hinting to a pivotal role of laryngeal motility alterations. The relationship between SBD and VNS‐induced LVCA supports the need to routinely investigate sleep respiratory and laryngeal motility patterns before and after VNS implantation.     

声带息肉、声带小结术后应用黄氏响声丸疗效观察

目的观察黄氏响声丸对显微喉手术切除声带息肉、声带小结术后疗效的影响。方法经直达喉镜显微镜下进行声带息肉、声带小结切除手术128例,随机分为观察组68例（在术后常规处理的基础上加用黄氏响声丸）和对照组60例（未州黄氏响声丸）,随访3个月,比较两组疗效。结果观察组治愈显效率为95．6％,对照组治愈显效率为81．7％,丽组比较差异具有统计学意义（P〈0．05）。结论声带息肉、声带小结行显微喉手术切除术后,在常规处理的基础上加用黄氏响声丸能够促进声带的恢复、缩短病程。     

寰枕、寰枢关节滑膜皱襞解剖观测及临床意义

目的：观察寰枕、寰枢关节中各关节有无滑膜皱襞存在，皱襞的形态、位置和组织学，探讨其临床意义。方法：对16例12岁以下小儿和8例成人防腐尸体的寰枕、寰枢关节中的各关节进行解剖观测。结果：无论成人或小儿，除了寰枢后正中关节外，其它关节均有滑膜皱襞存在，滑膜皱襞总出现率66．7％。寰枢前正中关节中皱襞位于上关节间隙，寰枕关节、寰枢外侧关节的皱襞主要分布于前外侧，多数皱襞呈月牙形。与成人相比，小儿组皱襞数量多，总出现率达72．34％(成人组仅58．3％)，小儿以大中型皱襞为主(58．35％)，成人以小型皱襞为主(62．5％)且无大皱襞。镜下观察儿童有三种不同的组织学类型，其中以脂肪型和纤维脂肪型为主(88．9％)。结论：推测在儿童寰枕、寰枢关节中有更多更大的滑膜皱襞，在受到外伤或炎症作用下，皱襞肿胀变大，位置改变，发生嵌顿，这很可能是小儿好发某些上颈椎疾病，如寰枢椎旋转畸形的解剖学基础。     

ABCLOVE嗓音训练法改善儿童声带小结发音功能的临床观察

目的探讨ABCLOVE嗓音训练法在儿童声带小结治疗中的应用,以及对患儿发声功能的临床改善效果。方法选取2019年1月至2021年3月收治的100例声带小结患儿为研究对象,利用随机数字表分组方式将患儿分为对照组和观察组各50例。对照组采用药物治疗及行为干预,观察组给予ABCLOVE嗓音训练法及行为干预治疗,每周1次,每次30分钟,共6周。比较两组干预前后电子喉镜下声带小结改善情况、声音嘶哑评估(grade roughness breathiness asthenia strained,GRBAS)和嗓音声学分析等指标。结果治疗后观察组总嘶哑度(grade,G)、粗糙声(roughness,R)评分较对照组下降明显(P<0.05),嗓音声学分析中基频微扰(jitter)、振幅微扰(shimmer)、声门噪声激发比(glottal to noise excitation ratio,GNE Ratio)指数观察组均显著低于对照组(P<0.05),最长发声时间(MPT)观察组较对照组明显延长(P<0.05),电子喉镜检查显示观察组治疗有效率、声带小结改善情况优于对照组(P<0.05),且两组治疗前后各参数均有显著改善(P<0.05)。结论ABCLOVE嗓音训练治疗儿童声带小结疗效显著,可有效改善患儿发音功能,降低嗓音嘶哑程度,改善患儿嗓音质量。     

3~5岁听障与健听儿童情感语调发音的声学特征研究

目的探讨3~5岁听障儿童情感语调发音的声学特征。方法选取3~5岁17例(3岁8例,4岁4例,5岁5例)佩戴助听器(hearing aid,HA)儿童(HA组)、51例(3岁19例,4岁17例,5岁15例)人工耳蜗植入(cochlear implant,CI)儿童(CI组)以及32例(3岁10例,4岁9例,5岁13例)健听(normal hearing,NH)儿童(NH组),以自编6个语义中性的高兴和难过情感语调测试语料分别检测各组两种情感语调的平均基频(F0)、基频标准差(F0 SD)、基频范围(F0 range)、平均强度(intensity)、强度标准差(intensity,SD)、强度范围(intensity range)及时长(duration),比较三组儿童情感语调的声学特征。结果三组儿童高兴和难过语调发音的平均基频、平均强度和时长差异无统计学意义(P>0.05);相比难过语调,NH组儿童高兴语调的基频标准差和基频范围更大,而HA组和CI组儿童的强度标准差和强度范围更大,与NH组儿童差异有统计学意义(P<0.05);各项声学指标值在不同年龄儿童间差异均无统计学意义(P>0.05)。结论在情感语调发音中健听儿童主要利用更多的频率变化来改变语调,而佩戴助听器和人工耳蜗植入儿童则倾向于用更多的强度变化来表达情感;听障儿童在情感语调发音中展示了对韵律线索的利用能力。     

中文版嗓音疲劳指数量表在职业用声者嗓音疲劳评估中的应用

目的 探索中文版嗓音疲劳指数量表(VFI)在职业用声者嗓音疲劳(VF)评估中的应用.方法 观察组为因嗓音疲劳就诊的职业用声者120例,对患者进行电子喉镜内镜窄带成像技术(NBI)检查,填写中文版VFI量表调查问卷.观察组根据电子喉镜NBI下检查再次分组慢性喉炎组(A组)、声带小结组(B组)、声带肿物组(C组).对照组为...     

Regenerative potential of basic fibroblast growth factor contained in biodegradable gelatin hydrogel microspheres applied following vocal fold injury: Early effect on tissue repair in a rabbit model

IntroductionPostoperative dysphonia is mostly caused by vocal fold scarring, and careful management of vocal fold surgery has been reported to reduce the risk of scar formation. However, depending on the vocal fold injury, treatment of postoperative dysphonia can be challenging.ObjectiveThe goal of the current study was to develop a novel prophylactic regenerative approach for the treatment of injured vocal folds after surgery, using biodegradable gelatin hydrogel microspheres as a drug delivery system for basic fibroblast growth factor.MethodsVideoendoscopic laryngeal surgery was performed to create vocal fold injury in 14 rabbits. Immediately following this procedure, biodegradable gelatin hydrogel microspheres with basic fibroblast growth factor were injected in the vocal fold. Two weeks after injection, larynges were excised for evaluation of vocal fold histology and mucosal movement.ResultsThe presence of poor vibratory function was confirmed in the injured vocal folds. Histology and digital image analysis demonstrated that the injured vocal folds injected with gelatin hydrogel microspheres with basic fibroblast growth factor showed less scar formation, compared to the injured vocal folds injected with gelatin hydrogel microspheres only, or those without any injection.ConclusionA prophylactic injection of basic fibroblast growth factor -containing biodegradable gelatin hydrogel microspheres demonstrates a regenerative potential for injured vocal folds in a rabbit model.     

腹膜外剖宫产的解剖学基础

目的：研究避免腹膜外剖宫产副损伤的方法；方法：作者对８９例晚期妊娠孕妇的反折腹膜缘和膀胱顶的位置及体表投影进行了测量。结果：孕妇年龄２６．９±４．１（２０～４０）岁；孕周３９．５±１．１（３７～４２）周。结果显示反折腹膜缘与脐和耻骨联合上缘间距分别为１５．８±４．０ｃｍ和５．７±１．９ｃｍ；膀胱顶与脐和耻骨联合上缘间距分别为１３．７±３．６ｃｍ和７．２±２．２ｃｍ。结论：在腹膜外剖宫产术时，应按反折腹膜缘及膀胱顶的位置与体表投影进行腹膜剥离。     

喉肌电图与喉肌诱发电位对甲状腺手术所致声带麻痹的评价

目的 :探讨喉肌电图 (LEMG)和喉体感诱发电位 (LSEP)对甲状腺手术所致声带麻痹的评估价值。方法 :对病程不同的 32例甲状腺手术所致单侧声带麻痹患者进行LEMG和LSEP检测并分析与临床预后的关系。结果 :不论是 2～ 6个月声带运动恢复组 ,还是未恢复组 ,LEMG和LSEP两种检查结果(波幅分别 6 5 .2± 2 2 .9μV和 4 4 .0± 2 8.2 μV)之间有高度一致性即其间差异无显著意义。不论是LEMG或是LSEP检查 ,2～ 6个月声带恢复组与未恢复组两组 (波幅分别 5 5 .4± 12 .7μV和 15 .4±15 .6 μV)之间差异有显著性意义。全部患者LSEP潜伏期明显延长 ,波幅降低 ,与对照组比较差异有显著意义。LEMG提示失神经电位增多。预后越好则LSEP和LEMG波幅越高。结论 :LSEP和LEMG检测有一致性 ,均可评估喉返神经损伤程度 ,对预测喉返神经损伤所致声带麻痹的预后有一定价值。