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Biomedical subjects

J L Henley-Cohn

Publications and source records attributed to J L Henley-Cohn.

3 recordsLinked to original sources

Artificial larynx prosthesis: comparative clinical evaluation.

The work pioneered by Drs. Singer and Blom established the clinical feasibility of controlled tracheoesophageal fistula for generation of fluent esophageal speech. There have been numerous practical difficulties that have been encountered with the use of voice prosthesis. Problems encountered are: extrusion, speech initiation delay, leakage around the prosthesis, stoma obstruction, and low volume output. A second generation laryngeal prosthesis is introduced for comparison. Its design incorporates features that will significantly improve the clinical problems encountered; extrusion is minimized; and the new prosthesis allows for one size to fit all patients. A clinical trial was established to directly compare the artificial speech generated by the currently existing laryngeal prosthesis. Each laryngectomy patient was fitted with three different devices and the resulting speech was evaluated. Video recordings of patients are presented to illustrate the type of speech produced by each device. Comparisons of intelligibility, fluency, volume, and patient preference are made. Results indicate that a significant variation in the speech obtained is critically dependent on the choice of prosthesis.

Consumer Behavior↗

Spastic dysphonia: treatment by selective section of the recurrent laryngeal nerve.

Selective section of the adductor branch of the recurrent laryngeal nerve appears to result in phonatory results similar to complete nerve section without the inherent morbidity. The abductor branch to the posterior cricoid-arytenoid muscle remains intact for glottic opening during inspiration. We emphasize the importance of careful preoperative patient evaluation as described by Dedo. All patients should be seen by a speech therapist and undergo a trial of speech therapy prior to surgical evaluation. A test block of the recurrent nerve with 1% xylocaine is imperative to allow the patient to hear the postoperative speech characteristics and give him a realistic expectation of the surgical result. We find that patients and referring professionals more readily accept the concept of selective nerve section.

Humans↗

Selective section of the recurrent laryngeal nerve for the treatment of spastic dysphonia: an experimental study and preliminary clinical report.

The experimental and clinical results of the surgical treatment of patients with spastic dysphonia by selective section of the adductor branch of the recurrent laryngeal nerve are described. Experimental selective nerve section in dogs appears to retain cordal abduction during inspiration while producing a partial adductor paralysis. Selective section of the recurrent laryngeal nerve has been performed in four patients with 18- to 24-month follow-up. Speech results have been good with maintenance of partial vocal cord motion. No patient has experienced a return of spasticity. We theorize that selective nerve section may decrease the likelihood of the long-term failure that has been seen with complete nerve section by preventing medial fixation of the paralyzed vocal cord.

Animals↗