Normal anatomy of the vocal folds.
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Humans↗
Biomedical subjects
R T Sataloff
Publications and source records attributed to R T Sataloff.
Gastroesophageal reflux laryngitis.
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Barium↗
Consequences of vocal cord hemorrhage.
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Adult↗
Voice disorders.
Many other diagnoses and treatments are of particular importance in caring for voice patients. Those discussed in this article are among the most common. The exacting demands of a professional singer or actor, his or her acute ability to analyze the body's condition, and his or her professional athlete's need for a nearly perfect result provide special challenges and gratification for physicians. However, a great many of our non-singer/actor patients are also extremely dependent on voice quality and endurance. Consequently, every patient with a voice complaint should be treated as Pavaroti or Sutherland would be treated, and every voice evaluation should be carried out systematically until a diagnosis has been made on the basis of positive evidence. The emergence of interdisciplinary teams, advanced instrumentation, and voice laboratories has made dramatic improvements in the standard of voice care, and the rapid development of voice as a subspecialty promises continuing advances in the care of voice disorders.
Humans↗
The impact of pollution on the voice.
Pollution is responsible for the presence of toxic substances and conditions throughout our environment. Inhalation of toxic pollutants may affect the voice adversely by direct laryngeal injury, by causing pulmonary dysfunction that results in voice maladies, or through impairments elsewhere in the vocal tract. Ingested substances--especially those that have neurolaryngologic effects--may also adversely affect the voice. Non-chemical environmental pollutants such as noise may also be responsible for voice abnormalities. Most of the information about the effects of pollution on the voice is anecdotal. Equipment and techniques that permit valid, reliable voice research have recently become available; and studies on the impact of pollution on communication, and specifically on voice, should be encouraged.
Air Pollutants↗
Male soprano voice: a rare complication of thyroidectomy.
A soprano voice from cricothyroid fusion is a rare complication following thyroidectomy. Thyroid surgeons should be aware of this possibility and recognize it early if voice pitch rises following thyroid surgery. This patient's unfortunate complication may prove fortuitous for phonosurgeons and their patients. Cricothyroid fusion may provide a better long-term retention of frequency elevation than traditional cricothyroid approximation. It is also a reversible procedure. Cricothyroid fusion should be investigated as an alternative to cricothyroid approximation for pitch modification.
Cicatrix↗
Office evaluation of dysphonia.
The office evaluation of dysphonia is complex. Proper medical care requires an in-depth history and comprehensive physical examination. Diagnosis and treatment are aided by objective assessment and quantification of voice function. Scientific and technologic advances over the last decade have resulted in substantial advances in the medical evaluation of dysphonia.
Ambulatory Care↗
Laser surgery of the larynx: the case for caution.
Laser surgery has been advocated for treatment of many laryngeal lesions. Although the CO2 laser has many advantages, its safe use requires special education of the surgeon and operating room team, and considerable surgical skill. Several dangers inherent in laser use for laryngeal surgery must be considered. These include vocal fold scarring secondary to thermal injury, loss of histopathologically important tissue through vaporization, airway fire and others. Laser-related complications must be considered whenever use of this instrument is contemplated.
Burns↗
Strobovideolaryngoscopy: results and clinical value.
Strobovideolaryngoscopy is a valuable addition to the diagnostic armamentarium because it allows the otolaryngologist to perform a detailed physical examination of the vibratory margin of the vocal fold. From 1985 through 1989, we performed 1,876 strobovideolaryngoscopy procedures, the majority on professional voice users. Previously, we reported findings on our first 486 strobovideolaryngoscopy procedures. Stroboscopic information influenced diagnosis or treatment in approximately one third. The present study was undertaken to determine whether additional experience had altered the clinical usefulness of the procedure. Diagnoses were noted before and after stroboscopy prospectively for 377 strobovideolaryngoscopy procedures performed during the calendar year 1989. In 53% of the procedures, strobovideolaryngoscopy resulted in no change in diagnosis. In 29%, preprocedure impressions were confirmed and additional diagnoses were made. In 18%, preprocedure diagnoses were found to be incorrect. The procedure has proven very helpful in caring for voice patients, modifying diagnoses in 47%, and confirming uncertain diagnoses in many of the other patients studied.
Humans↗
Lipoinjection for unilateral vocal cord paralysis.
Injection of Teflon paste is a commonly accepted procedure to improve the caliber of voice in unilateral vocal cord paralysis. There are several drawbacks to Teflon injection, among them respiratory obstruction (from overinjected Teflon) and unsatisfactory voice quality (Teflon causes stiffness of the vocal folds). This paper is a preliminary report on lipoinjection instead of Teflon injection into a paralyzed vocal fold. Fat appears to impart a soft bulkiness to the injected cord, while allowing it to retain its vibratory qualities. It is autologous material and can be retrieved if excessively overinjected. The fate of autologous fat injected into a paralyzed vocal cord remains unknown. Most of the literature on lipoinjection concerns repairs of depressed scars or breast augmentation. Our longest follow-up has been 12 months. Three patients have had this procedure, and the results appear to be very encouraging.
Abdominal Muscles↗
Care of the professional voice.
Care of the professional voice user, particularly the professional singer, requires that the otolaryngologist acquire special training. This group of patients demands gentle and appropriate treatment, rarely surgery, for a wide range of conditions that may affect vocal performance.
Humans↗
Good hearing-conservation program detects impairment and saves lives.
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Cranial Nerve Neoplasms↗
Hearing loss in musicians.
Hearing is of special vocational importance in musicians. Musical performance may create sounds sufficiently intense to cause sensorineural hearing loss. Although such losses are usually not severe enough to be compensable under American Academy of Otolaryngology guidelines for occupational hearing loss, they may interfere with the musician's ability to perform the daily tasks of his or her profession. A review of the literature on occupational hearing loss in musicians reveals a substantial need for further research.
Ear Protective Devices↗
Cornelia de Lange syndrome. Otolaryngologic manifestations.
Cornelia de Lange syndrome (CDLS) is characterized by multiple congenital malformations and mental retardation. New studies have documented otolaryngologic abnormalities. We examined 45 patients with CDLS. Virtually all had hearing loss, and most had impaired language development. Other otolaryngologic abnormalities, including external auditory canal stenosis and cleft palate, were also common. Because of the high incidence of otolaryngologic abnormalities, and the need for early intervention, it is important for otolaryngologists to recognize CDLS manifestations in the head and neck.
Adolescent↗
Embryology of the facial nerve and its clinical applications.
Although many studies have investigated facial nerve development, most have been limited by available specimens and have not provided a comprehensive description of the development of this important structure. Even the best and most comprehensive articles on this subject have not systematically integrated the descriptions of facial nerve embryology with a summary of the development of other otologic structures. This study describes the parallel development of the facial nerve and ear, emphasizing practical applications for the otologic surgeon. The validity of these predictions has been tested through surgical procedures on patients with malformed ears.
Child↗