Adipose stromal cells improve healing of vocal fold scar: Morphological and functional evidences

OBJECTIVES/HYPOTHESIS: Adipose derived stromal cells (ASCs) are abundant and easy to prepare. Such cells may be useful for treating severe vocal disturbance caused by acute vocal fold scars. STUDY DESIGN: Prospective animal experiments with controls. METHODS: Twenty New-Zealand white rabbits were used in the present study. We evaluated vocal fold healing, with or without injection of autologous ASCs, after acute scarring. A defined lesion was created and the ASCs were immediately injected. Vocal fold regeneration was evaluated histomorphometrically and via viscoelastic analysis using an electrodynamic shaker. RESULTS: Six weeks after ASC injection, vocal folds exhibited significantly less inflammation than control folds (P < 0.005). In addition, hypertrophy of the lamina propria and fibrosis were significantly reduced upon ASC injection (P < 0.02). The decrease in viscoelastic parameters was less important in the ASC injected group compared to the noninjected group (P = 0.08). CONCLUSION: Injection of autologous ASCs improved vocal fold healing in our preclinical model. Further studies are needed, but this method may be useful in humans. LEVEL OF EVIDENCE: NA. Laryngoscope, 126:E278-E285, 2016

INTRAORAL AIR PRESSURE MEASURES IN ADULTS

The effect of age, gender, and repeated measures on intraoral air pressure (P0) was examined. Sixty adults comprised of ten males and ten females in each of three age groups (i.e., 20 to 39, 40 to 59, and 60 to 83 years) participated. P0 was assessed during voiceless stop plosive /p/ productions in repeated vowel/consonant syllables. The three medial plosives of a seven syllable train were averaged to comprise a token. Five tokens were obtained and averaged for each of three trials. Thus each participant contributed 105 syllables and a subsequent three P0s for analyses. There was no statistically significant difference in P0 as a function of age or gender (p>.05). These findings support the conception that P0 remains stable throughout adulthood and is not dependent on gender. Differences in repeated measures of P0 attained statistical significance (p = .03), however the mean differences between trials (.23 cm H20) were negligible and deemed to be clinically insignificant. Thus, across a short sampling session, P0 is a relatively stable measurement and does not change as a function of age or gender

Vocal Fold Injection: Review of Indications, Techniques, and Materials for Augmentation

Vocal fold injection is a procedure that has over a 100 year history but was rarely done as short as 20 years ago. A renaissance has occurred with respect to vocal fold injection due to new technologies (visualization and materials) and new injection approaches. Awake, un-sedated vocal fold injection offers many distinct advantages for the treatment of glottal insufficiency (vocal fold paralysis, vocal fold paresis, vocal fold atrophy and vocal fold scar). A review of materials available and different vocal fold injection approaches is performed. A comparison of vocal fold injection to laryngeal framework surgery is also undertaken. With proper patient and material selection, vocal fold injection now plays a major role in the treatment of many patients with dysphonia

Fundamental frequency estimation of low-quality electroglottographic signals

Fundamental frequency (fo) is often estimated based on electroglottographic (EGG) signals. Due to the nature of the method, the quality of EGG signals may be impaired by certain features like amplitude or baseline drifts, mains hum or noise. The potential adverse effects of these factors on fo estimation has to date not been investigated. Here, the performance of thirteen algorithms for estimating fo was tested, based on 147 synthesized EGG signals with varying degrees of signal quality deterioration. Algorithm performance was assessed through the standard deviation σfo of the difference between known and estimated fo data, expressed in octaves. With very few exceptions, simulated mains hum, and amplitude and baseline drifts did not influence fo results, even though some algorithms consistently outperformed others. When increasing either cycle-to-cycle fo variation or the degree of subharmonics, the SIGMA algorithm had the best performance (max. σfo = 0.04). That algorithm was however more easily disturbed by typical EGG equipment noise, whereas the NDF and Praat's auto-correlation algorithms performed best in this category (σfo = 0.01). These results suggest that the algorithm for fo estimation of EGG signals needs to be selected specifically for each particular data set. Overall, estimated fo data should be interpreted with care

Three registers in an untrained female singer analyzed by videokymography, strobolaryngoscopy and sound spectrography

There has been a lack of objective data on the singing voice registers, particularly on the so called "whistle" register, occurring in the top part of the female pitch range, which is accessible only to some singers. This study offers unique strobolaryngoscopic and high-speed (7812.5 images/s) videokymographic data on the vocal fold behavior of an untrained female singer capable of producing three distinct voice qualities, i.e., the chest, head and whistle registers. The sound was documented spectrographically. The transition from chest to head register, accompanied by pitch jumps, occurred around tones 134-C#5 (500-550 Hz) and was found to be associated with a slight decrease in arytenoids adduction, resulting in decrease of the closed quotient. The register shifts from head to whistle, also accompanied by pitch jumps, occurred around tones E5-B5 (670-1000 Hz) without any noticeable changes in arytenoids adduction. Some evidence was found for the vocal. tract influence on this transition. The mechanism of the vocal fold vibration in whistle register was found principally similar to that at lower registers: vibrations along the whole glottal length and vertical phase differences (indicated by sharp lateral peaks in videokymography) were seen on the vocal folds up to the highest tone G6 (1590 Hz). (c) 2008 Acoustical Society ofAmerica