Biomedical subjects
Publications and source records attributed to M C Danoy.
A left-handed man presented with a partial hemispheric disconnection syndrome of traumatic origin composed by a left hand unilateral agraphia, a left hand tactile anomia, a left visual field anomia, a left visual field alexia and a partial left ear extinction for verbal material. MRI of the brain showed lesion involving the trunk of the corpus callosum.
Based on our observations of vocal dysfunction modes, we set up a classification of dysfunctions. Most often, we encounter a "prolonged and usual vocal forcing on an anatomically normal larynx". This forcing often essentially predominates breathing, but it may predominate the larynx, in the posterior glottis or on the vibrating area of the vocal cords. We individualized the very specific group of dysphonias with limited tone where the forcing in located, especially in the resonators. We reviewed the dysphonias with modified larynx, by secondary lesions or primitive pathologies. Analysis of the vocal dysfunction mode makes it possible to establish a therapeutic programme adapted to each case with a functional aim.
The creation of a structure adapted to serious head injuries, in the awakening phase of a coma, enables early treatment of these patients upon leaving intensive care. Along with a pluridisciplinary team, speech therapists will help establish non-verbal communication by setting up a yes-no code and by favouring and programming the resumption of deglutition before soliciting verbal communication and recuperation of the memory and all the cognitive functions.
The pharyngeal video fibroscopy (P.V.F.) should complete the classical diagnostical management of each snoring associated with obstructive sleep apnea. Easily made on a seated awake patient the P.V.F. is the one dynamical pharyngeal procedure. It also let see the snoring and reproduce the upper airway obstruction. The Müller test seats the level of this obstruction, helps the surgeon in the choice of the procedure and should reduce the failure rate.
The pharynx, as the junction of the aero-digestive pathways, is situated in the centre of the cervico-facial region. The description of its anatomic components will be complemented by a study of the muscular-aponeurotic features, that the pharynx forms with its surrounding regions, presenting a complex velo-pharyngo-facial structure, the anatomic unity of which will be confirmed by a functional unit.
The authors report on one case of pharyngolaryngeal extraosseous Ewing's sarcoma. This is a very rare tumor which preferentially has a paravertebral or retroperitoneal location. The difficult histological diagnosis is greatly facilitated by the use of tumoral markers. The treatment implemented consisted of a "conventional" Cisplatin 5 FU chemotherapy, which allowed an almost complete clinical recession after 3 courses, then of external radiation therapy. The evolution of these tumors still remains unpredictable. Regional metastases to the lymph nodes are rare, and they are usually remote and mainly pulmonary. Lastly, the merits of computed tomography for the follow-up of these intramural lesions of the larynx must be emphasized.
Numerous cases of early dysphonia in children are due to congenital lesions of the vocal cord. Others, developing later, appear within a context of maltreatment of the vocal cords, and become part of the child's psychological and psychomotor developmental disorder. Hearing and seeing dysphonia are the two parts of our diagnostic stage, assisted by the use of optic fibres and audiovisual methods. Treatment must be global, putting dysphonia back into its proper context, leaving a substantial part to vocal re-education, as laryngeal microsurgery only comes into play when the result is inadequate, or when the vocal imperatives of a child musician lead to that choice.
Voice clinicians, as well as singers, always correlate the assessment of the singing voice to the vocal and corporal gestures that model singing, and among these parameters, especially timbre. The authors have shown how and what to see in the timbre; first of all, through analysis of the voice by oscillography and sonagraphy, then through observation of the singing act in artists, with special interest for dynamic recordings by vuccal and nasal fibroscopy. In this manner, each variation of the timbre heard clearly corresponds to modifications of the glottic vibratory cycle, volume changes of the resonators, pharynx, oropharynx and buccal cavity. The analysis of the action of the different muscles coming into play in singing, their synergies and their antagonistic effects, give a physiological basis to the singer's vocal work. This analysis also makes it possible to more effectively guide the rehabilitation of dysacusia which effect the timbre.
Explore the source record for details and available documents.
After underlining the frequency of organic lesions observed in functional diseases of vocal cords, emphasis is placed on the importance of the phonetogram in their evaluation and video-laryngo-stroboscopic investigation in their diagnosis. When surgery is necessary, stainless steel instruments are preferred to the laser. Respective isolated or associated vocal reeducational and surgical indications are discussed, and the establishment of a team including laryngologist, phoniatrist and orthophonist recommended to ensure most effective results.