54 research outputs found
Editorial to the first issue to the UNAV-JMS (University of Navarra-Journal for Medical Students)
Introducing a new dosimeter for the assessment and monitoring of vocal risk situations and voice disorders
Summary: Purpose. There are many physiological parameters recorded by devices that are becoming more
affordable, precise and accurate. However, the lack of development in the recording of voice parameters from
the physiological or medical point of view is striking, given that it is a fundamental tool for the work of many
people and given the high incidence and prevalence of voice pathologies that affect people’s communication. In
this paper we perform a complete literature review on the dosimeters used in voice research and to present a pro-
totype dosimeter with a pilot study to show its capabilities.
Method. We conducted a literature review using the keywords [MONITORING], [PHONATION], [ACCU-
MULATOR], [PORTABLE], [DOSIMETRY], [VOICE] searching in PubMed, Trip Database, HONcode, and
SciELO search engines. From our review of dosimeter designs, we created our own prototype consisting of two
main components: a Knowles Electronics BU-7135-0000 accelerometer mounted on a neck brace; and the ultra-
low power MSP430FR5994 microcontroller. The selected sampling frequency was 2048 Hz. The device calculates
the F0 every 250 ms and the amplitude and phonation activity every 31.25 ms. A pilot study was conducted using
2 subjects: one male during 11 days and one female during 14 days.
Results. This work includes devices that have been created during the last 45 years as tools for the diagnosis and
monitoring of the treatment of cases of vocal pathology and for the detection of phonatory patterns or risk situa-
tions for developing voice disorders or vocal pathologies. We also present recordings with our new device on the
pattern of daily talk time, the fundamental frequency and the relative intensity of two subjects on different days.
Conclusions. Interesting work has been done in the development of voice dosimeters with different approaches.
In our experience it is not possible to access them for research and they are not yet in clinical use. It is possible
that a joint approach with voice and voice disorders professionals and engineers working closely together could
take advantage of current technology to develop a fully portable, useful, and efficient system
A giant paraesophageal hiatal hernia causing vocal fold paralysis
We report the case of a patient who presented with severe dysphonia as a consequence of a giant hiatal hernia that was paralysing the patient’s vocal folds
Spindle cell carcinoma: Two instances mistaken for vocal polyps
Spindle cell carcinoma is a variant of squamous carcinoma, with
behavior that is apparently more aggressive than that of squamous
carcinoma and that can produce distant lymphatic metastasis.
It was first described by Virchow in 1864 [1], but the origin of the
tumor is still not clear. The tumor is biphasic, with an epidermal
component and a sarcomatous component involving spindle cells;
transition zones between these components can be found [2–5]. In part
due to this peculiar and complex nature, the tumor has accumulated
various names since it was first described: sarcomatoid tumor, carci-
nosarcoma, pleomorphic carcinoma, collision tumor, etc. [2,5,6]
Fonación y tomografía por emisión de positrones (PET)
En el momento actual disponemos de herramientas precisas para diagnosticar
y valorar los trastornos de la voz. Esto nos permite desarrollar
un plan de tratamiento dirigido a cada problema concreto. No obstante,
es preciso establecer además del diagnóstico, la severidad de esa disfonía
y en que medida influye este trastorno en la vida del paciente.
Se revisan los conceptos de deficiencia, discapacidad y minusvalía en
relación con los trastornos de la voz y de acuerdo con herramientas
contrastadas y validadas para establecer el grado de afectación de la
voz en cada trastorno concreto.
Se revisan las escalas del GRABS, el índice de severidad de la disfonía
(SDI) y el índice de disfunción vocal. El empleo de dichas herramientas
así como de la utilización de la terminología aprobada recientemente
por la OMS en la clasificación internacional del funcionamiento de la
discapacidad y de la salud permitirán establecer grados de severidad de
la disfonía y planificar tratamientos integrales más eficaces
Quiste del cuarto arco branquial en la membrana tirohioidea: un difícil diagnóstico diferencial con el laringocele mixto
We present a case of a 62-year-old female patient with a right latero-cervical mass and an enlarged arytenoepiglottic fold, that caused voice disturbances. Computed tomography of the neck depicted an unilocular and homogeneous well-defined cyst located in the right parapharyngeal space that extended through the thyrohyoid membrane. It was initially diagnosed of mixed laryngocele. During surgical resection, no connexion between the lesion and laryngeal ventricle was detected, so the final diagnosis was branchial cyst. We discuss the pathogenicity and clinical, radiological and histological findings that facilitate differential diagnosis between mixed laryngocele and branchial cysts, mainly those derived from the second and fourth clefts. The radiological and histological findings in both lesions may be similar, so only the communication with the larynx, or its absence, can solve diagnostic doubts, course
Voz del anciano
La vejez es en sí un fenómeno biológico que no implica necesariamente
una enfermedad. Los fenómenos biológicos del envejecimiento se inician
en edades muy tempranas y tiene la capacidad de modificarse,
preveerse y compensarse.
La educación y la preparación para posibles deterioros debe de ser contemplada
desde un plano preventivo. En el ser humano la aparición del
lenguaje y su vehículo habitual, la voz; representó la posibilidad de
aumentar su longevidad.
El deterioro vocal del anciano se conoce como presbifonía y en ocasiones
interfiere significativamente en la capacidad de comunicación y en
la calidad de vida de las personas ancianas. Al considerar la presbifonía
o voz senil hay que distinguir dos situaciones clínicas distintas desde el
punto de vista conceptual: la disfonía del anciano y la disfonía en el
anciano.
Se comentan los aspectos del envejecimiento en relación con la voz, la
valoración y la caracterización de la voz en el anciano y las estrategias
para prevenir el deterioro y tratar los trastornos específicos de la voz en
las personas mayores, bien sea desde el punto de vista funcional o
rehabilitación o bien mediante cirugía
Ear, nose and throat manifestations in pemphigus vulgaris
Pemphigus vulgaris (PV) is an autoimmune disease characterized by mucocutaneous intraepithelial blisters and pathogenic autoantibodies against desmoglein 3. There are two clinical forms: mucosal (MPV) and mucocutaneous (MCPV). The frequency of ear, nose and throat (ENT) involvement in PV is not clearly defined. Only a few isolated individual cases have been reported.
OBJECTIVES: The objective of our study was to determine the incidence of ENT involvement in patients with PV.
PATIENTS: We studied prospectively all 16 patients diagnosed with PV and treated in the Department of Dermatology of the University Clinic of Navarra between 2001 and 2005. They were 10 cases of MPV and six cases of MCPV. All patients were evaluated for ENT manifestations by endoscopic examination.
RESULTS: Of the 16 patients, 13 presented with throat symptoms (81%), 12 pharyngeal (75%) and seven laryngeal symptoms (44%). Fourteen patients (88%) had active PV lesions on endoscopic evaluation (eight patients had active lesions on both pharyngeal and laryngeal mucosa, four had PV lesions only on laryngeal mucosa and two had PV lesions on pharyngeal mucosa). Laryngeal lesions were most commonly present in MPV patients. The frequency of nasal symptoms (38%) was lower than active PV lesions (62%) found on ENT examination. Oral symptoms and oral active PV lesions were the most frequent findings (94%). Only three patients with MCPV showed erosions on the external auditory canal.
CONCLUSIONS: As ENT endoscopy allows more extensive areas of mucosa to be examined than simple visual inspection, we recommend that it be included in the examination of all patients with PV. By obtaining more complete information concerning the extent of the disease, a more accurate diagnosis can be made, better choice of drug and dose may be decided and, ultimately, response to treatment may be improved
Voz del niño
En el curso de la vida la voz sufre diferentes cambios que obedecen a
factores de desarrollo y en los que intervienen de manera decisiva el
sistema nervioso y el sistema hormonal.
La voz del niño y, por tanto la disfonía en el niño requiere una evaluación
precisa y específica, no sólo desde el punto de vista instrumental
sino también perceptual y en evaluación logopédica.
Se insiste en la protocolización de elaboración de trastornos de voz en
el niño, la revisión de los factores etiológicos, los factores predisponentes
y en aquellos aspectos preventivos y de higiene vocal que evitarán el
desarrollo de trastornos de la voz y lesiones orgánicas en la laringe de
los niños que puedan condicionar problemas en la edad adult
Discapacidad vocal
En el momento actual disponemos de herramientas precisas para diagnosticar
y valorar los trastornos de la voz. Esto nos permite desarrollar
un plan de tratamiento dirigido a cada problema concreto. No obstante,
es preciso establecer además del diagnóstico, la severidad de esa disfonía
y en que medida influye este trastorno en la vida del paciente.
Se revisan los conceptos de deficiencia, discapacidad y minusvalía en
relación con los trastornos de la voz y de acuerdo con herramientas
contrastadas y validadas para establecer el grado de afectación de la
voz en cada trastorno concreto.
Se revisan las escalas del GRABS, el índice de severidad de la disfonía
(SDI) y el índice de disfunción vocal. El empleo de dichas herramientas
así como de la utilización de la terminología aprobada recientemente
por la OMS en la clasificación internacional del funcionamiento de la
discapacidad y de la salud permitirán establecer grados de severidad de
la disfonía y planificar tratamientos integrales más eficaces
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