Vocal rehabilitation after total laryngectomy.

Vocal rehabilitation after total laryngectomy

Foreign Body Aspiration in Northern Ghana: A Review of Pediatric Patients

Background. Foreign body (FB) aspiration requires a high index of suspicion for diagnosis and prompt management to avoid morbidity and mortality. This retrospective study was conducted to review pediatric foreign body aspiration at the Ear, Nose and Throat (ENT) Unit of the Tamale Teaching Hospital (TTH). Materials and Methods. The theater records of children managed for foreign body aspiration from January 2010 to December 2016 at the ENT Unit of TTH were retrieved and data summarized with respect to age, gender, indications for bronchoscopy, nature of foreign body, location of foreign body, and outcome of the bronchoscopy procedure. Results. A total of 33 children were managed within the five-year study period and comprised 16 (48.5%) males and 17 (51.5%) females. The commonly aspirated FBs were groundnuts (13, 39.4%) and metallic objects (7, 21.1%). The peak incidence occurred in children aged ≤ 3 years. The foreign bodies (FBs) were commonly localized to the right (24.2%) and left (24.2%) main bronchi, respectively. One patient had emergency tracheostomy for failed bronchoscopy. Conclusion. Groundnuts were the most commonly aspirated foreign body with most of the FBs localized in the bronchi

The Role of Esophagus in Voice Rehabilitation of Laryngectomees

The total laryngectomy is a standard procedure of laryngeal carcinoma treatment which leaves multiple persistent consequences on a laryngectomized person. After laryngectomy, all of patients cannot speak loudly, and 10–58% patients have a dysphagia. In such changed anatomical condition, the esophagus has a key function in two of three primary approaches to voice—speech rehabilitation of laryngectomized patients: esophageal and tracheoesophageal speech therapy method because one of these is the only acceptable solution of substitute alaryngeal speech. In esophageal speech, the esophagus has the role of speech air reservoirs since the respiratory and digestive pathways are permanently separated after the procedure. In the production of tracheoesophageal speech, the tracheoesophageal fistula and the esophagus allow the recommunication of these pathways and the use of air from the lungs for speech. There are several prerequisites for successful esophageal and tracheoesophageal speech. After tracheoesophageal puncture and insertion, the tracheoesophageal prosthesis may occur different complications in the early or late postoperative period in 10–60% of patients. The quality of alaryngeal voice is very different from the quality of laryngeal voice, but allows communication to laryngectomees

The efficiency of bag-valve mask ventilations by medical first responders and basic emergency medical technicians

Bag-valve mask (BVM) ventilation maintains a patient\u27s oxygenation and ventilation until a more definitive artificial airway can be established. In the prehospital setting of a traffic collision or medical aid scene this is performed by an Emerency Medical Technician or medical first responder. Few studies have looked at the effectiveness of Bag-valve masks (BVM) or the complication rate of ventilating an unprotected airway. The purpose and goal of this study is to educate both medical first responders and basic emergency medical technicians

A biomimetic vocalisation system for MiRo

There is increasing interest in the use of animal-like robots in applications such as companionship and pet therapy. However, in the majority of cases it is only the robot's physical appearance that mimics a given animal. In contrast, MiRo is the first commercial biomimetic robot to be based on a hardware and software architecture that is modelled on the biological brain. This paper describes how MiRo's vocalisation system was designed, not using pre-recorded animal sounds, but based on the implementation of a real-time parametric general-purpose mammalian vocal synthesiser tailored to the specific physical characteristics of the robot. The novel outcome has been the creation of an 'appropriate' voice for MiRo that is perfectly aligned to the physical and behavioural affordances of the robot, thereby avoiding the 'uncanny valley' effect and contributing strongly to the effectiveness of MiRo as an interactive device

A radial basis classifier for the automatic detection of aspiration in children with dysphagia

BACKGROUND: Silent aspiration or the inhalation of foodstuffs without overt physiological signs presents a serious health issue for children with dysphagia. To date, there are no reliable means of detecting aspiration in the home or community. An assistive technology that performs in these environments could inform caregivers of adverse events and potentially reduce the morbidity and anxiety of the feeding experience for the child and caregiver, respectively. This paper proposes a classifier for automatic classification of aspiration and swallow vibration signals non-invasively recorded on the neck of children with dysphagia. METHODS: Vibration signals associated with safe swallows and aspirations, both identified via videofluoroscopy, were collected from over 100 children with neurologically-based dysphagia using a single-axis accelerometer. Five potentially discriminatory mathematical features were extracted from the accelerometry signals. All possible combinations of the five features were investigated in the design of radial basis function classifiers. Performance of different classifiers was compared and the best feature sets were identified. RESULTS: Optimal feature combinations for two, three and four features resulted in statistically comparable adjusted accuracies with a radial basis classifier. In particular, the feature pairing of dispersion ratio and normality achieved an adjusted accuracy of 79.8 ± 7.3%, a sensitivity of 79.4 ± 11.7% and specificity of 80.3 ± 12.8% for aspiration detection. Addition of a third feature, namely energy, increased adjusted accuracy to 81.3 ± 8.5% but the change was not statistically significant. A closer look at normality and dispersion ratio features suggest leptokurticity and the frequency and magnitude of atypical values as distinguishing characteristics between swallows and aspirations. The achieved accuracies are 30% higher than those reported for bedside cervical auscultation. CONCLUSION: The proposed aspiration classification algorithm provides promising accuracy for aspiration detection in children. The classifier is conducive to hardware implementation as a non-invasive, portable "aspirometer". Future research should focus on further enhancement of accuracy rates by considering other signal features, classifier methods, or an augmented variety of training samples. The present study is an important first step towards the eventual development of wearable intelligent intervention systems for the diagnosis and management of aspiration