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Biomedical subjects

M D Trudeau

Publications and source records attributed to M D Trudeau.

15 recordsLinked to original sources
PubMed2000

Paradoxical vocal cord dysfunction in juveniles.

OBJECTIVE: To evaluate demographic and videolaryngoscopic features in a large series of juveniles with paradoxical vocal cord dysfunction (PVCD). DESIGN: Case series data from videolaryngoscopic tapes retrospectively evaluated in a masked, controlled fashion, and demographic data collected via retrospective medical chart review. SETTING: A tertiary care otolaryngology and speech pathology referral center. PATIENTS: Twenty-two patients with PVCD aged 18 years and younger diagnosed as having PVCD at The Ohio State University Voice Institute, Columbus. MAIN OUTCOME MEASURES: Age, sex, social history, and medical history (demographic); epiglottic position, arytenoid and interarytenoid appearance, phase 0 stability, true vocal cord respiratory motion, degree of anteroposterior (AP) constriction, and false vocal cord adduction (videolaryngoscopic). RESULTS: Of 22 patients, 18 were girls, and 12 had significant social stressors, particularly organized sports. Nineteen patients had posterior laryngeal changes commonly found in gastroesophageal reflux disease. Twelve patients demonstrated abnormal true vocal cord adduction during quiet respiration. Seven patients demonstrated supraglottic anteroposterior constriction and false vocal cord approximation during phonation. CONCLUSIONS: Juvenile PVCD is more common in girls and is associatedwith social stresses. Anatomic laryngeal changes typically associated with gastroesophageal reflux disease are extremely common in these patients. Juveniles with PVCD frequently demonstrate abnormal true vocal cord adduction during quiet respiration. We recommend that initial evaluation of juvenile patients for possible PVCD be conducted via transnasal fiberoptic laryngoscopy while the patient is asymptomatic, and that strong consideration be given to empiric pharmacological treatment of gastroesophageal reflux disease in juveniles diagnosed as having PVCD.

Adolescent↗
PubMed1999

Endoscopic and stroboscopic description of adults with paradoxical vocal fold dysfunction.

The purpose of this study was to determine if endoscopic and stroboscopic parameters of voice were normal between attacks of paradoxical vocal fold dysfunction (PVFD). Fifty adults (38 females, 12 males) and 54 adult controls (40 females, 14 males) were examined via endoscopy with and without stroboscopy. Endoscopy indicated paradoxical adduction of the folds during the respiratory cycle of all 50 participants with PVFD, although they were asymptomatic. Atypical laryngeal configurations were observed including abnormality of the anterior-posterior dimension and ventricular fold medialization in both groups of subjects. Stroboscopy demonstrated abnormalities including unstable zero phase, decreased amplitude of vibration, decreased mucosal waves, and phase asymmetry primarily for the PVFD subjects alone. Results indicate that persons with PVFD demonstrate subtle laryngeal abnormality endoscopically and stroboscopically when dyspnea is not reported. This supports the hypothesis that PVFD is not episodic but exists as a continuum of laryngeal instability that may, due to various precipitating factors, be exacerbated to breathing attacks.

Adult↗
PubMed1997

Changes in sustained production tasks among women with bilateral vocal nodules before and after voice therapy.

The purpose of the current study was to determine how maximum phonation duration (MPD) of five notes (C4, D4, E4, F4, G4) sustained on /o/, sustained vowels (/i/, /ae/, /a/, /u/), and s/z ratio (sustained /s/ and /z/) changed during voice therapy for vocal nodules. Voices of adult females before treatment and after resolution of vocal nodules were analyzed via the PM Pitch Analyzer. Treatment included tension reduction, abuse identification and elimination, laryngeal strengthening, and home exercises. Results indicate there was no significant difference in maximum phonation duration or S/Z ratio before and after treatment. Results revealed that females with vocal nodules demonstrate measurements before therapy similar to measures considered to be normal in persons without vocal nodules. Application of findings to clinical practice is discussed.

Adult↗
PubMed1990

Acoustic characteristics of female tracheoesophageal speech.

An acoustical description of speech and voice produced by 10 female tracheoesophageal (TE) speakers is provided. In light of results from earlier descriptions based on male TE speakers, and based on t-test comparisons, the female speakers produced generally more perturbation in fundamental frequency. Potential factors affecting this increase were elapsed time since the laryngectomy and extent of the laryngectomy surgery. The data from this investigation, however, indicate that in oral reading the characteristics of TE speech, including F0, may be highly similar regardless of speaker gender.

Aged↗
PubMed1989

The effects of radiation on tracheoesophageal puncture. A retrospective study.

A census survey of the records of the Department of Otolaryngology. The Ohio State University, Columbus, identified 108 patients with tracheoesophageal puncture (TEP) for voice restoration. Fifty-one patients received radiation therapy in the management of the disease, 50 did not, and seven were unavailable for follow-up. The records were reviewed and chi 2 tests applied to identify possible effects of radiation therapy on the achievement of TE speech and on TEP-related complications. Results of a census indicate that, with the exception of radiotherapy, the two groups of patients were highly similar with respect to ultimate achievement of TE speech and to the frequency with which complications occurred, eg, stoma stenosis or leakage via TE fistula. These findings support the incorporation of TEP with the total laryngectomy procedure, even for patients for whom radiation therapy is indicated.

Alcoholism↗
PubMed1988

Use of the tracheostoma valve in the marking of contrastive stress and sentence intonation.

Two proficient tracheoesophageal speakers experienced in use of the tracheostoma valve (TSV) produced a total of 64 examples of "Bev loves Bob." These productions varied with location of contrastive stress, type of sentence intonation, and use of TSV. Thirty-four listeners judged the utterances in terms of stress placement and intonation contour simultaneously. An analysis of variance of the perceptual results indicated that TSV use reduced speaker ability to signal the two suprasegmental features; however, locus of the suprasegmental features, particularly stress placement, appeared to exert a stronger effect.

Female↗
PubMed1988

A multidimensional scaling study of esophageal vowels.

A multidimensional scaling experiment was conducted to determine the perceptual structure of 11 American English vowels produced by a competent esophageal speaker. Estimates of perceptual distance among these vowels were obtained using a 9-point similarity/dissimilarity scale and were analyzed using an individual differences scaling algorithm (INDSCAL). A three-dimensional perceptual space was produced. The three perceptual dimensions corresponded to tongue advancement, vowel height, and rhotacization. These three dimensions were then correlated with selected bark scale transformed acoustic vowel measurements. The perceptual dimensions 1-3 corresponded most closely to F3-F2, F1-F0, and F3, respectively. Little difference was found between the perceptual structure of esophageal vowels and laryngeal vowels, although it is suggested that the correlation between some of the acoustic measures (such as F0) and the perceptual dimensions may change as a function of individual speaker differences due to postsurgical capabilities (anatomical and physiological) and/or method of voice restoration.

Aged↗
PubMed1987

A comparison of the speech acceptability of good and excellent esophageal and tracheoesophageal speakers.

Thirteen esophageal speakers (8 male, 5 female) and 12 tracheoesophageal (t-e) speakers (7 male, 5 female) were placed into eight groups based on gender, voice type, and speaking proficiency (excellent or good). Audio recordings of each speaker reading the Rainbow Passage (Fairbanks, 1960) were made. The resultant samples were judged for acceptability of speech by 25 naive listeners trained in use of a five-point equal-appearing-interval scale. An analysis of variance of the listener data indicated that speaker proficiency but not voice type had a significant effect on judgments of acceptability, indicating that the listeners perceived no difference in the acceptability of esophageal and t-e speech.

Adult↗
PubMed1986

Vocal restorative surgery: why wait?

The case histories of 36 laryngectomees with vocal restorative surgery from the Department of Otolaryngology were reviewed to determine the patient's current mode of speech and number and type of complications to recovery and rehabilitation. The patients comprised two groups: 21 with tracheoesophageal fistula (tef) at the time of laryngectomy (primary) and 15 with tef subsequent to laryngectomy (secondary). Results of the review indicated that while approximately 10% fewer patients in the primary group were using a surgically restored voice, none of the surviving primary group remained aphonic. In contrast, 27% of the surviving secondary group failed to develop some form of verbal communication. When the complication rate is identified, vocal restorative surgery at the time of laryngectomy appeared to be very successful in initiating the rehabilitation process without compromising sound oncological procedures.

Female↗
PubMedDate not supplied

Reading assessment post head injury: how valid is it?

The purpose of this study was to identify the passage dependency for three reading tests applied to the closed head injured (CHI) population and to determine whether reading the passage resulted in improved accuracy in responding to passage-related questions. Based on the performance of 10 CHI adults, passage dependency was low for all three tests. Only the Reading Comprehension Battery for Aphasia scores improved significantly when the subjects read the passages prior to responding. The results parallel those found with aphasic subjects and raise questions concerning the validity of these tests in assessing communication dysfunction post-CHI.

Adult↗