S188 – Development of Laryngoscope with a Built-in Laser Ruler

S188 – Development of Laryngoscope with a Builtin Laser Ruler Jin-Choon Lee, MD (presenter); Soo-Geun Wang, MD; Eui-Kyung Goh, MD; Yong-Wan Kim, MD; Jin-Woo Lee, MD; Young-Ok Lee, MD; Jong-Kil Lee, MD OBJECTIVES: The endoscope for inspection of body cavities has improved the accuracy of diagnosis. However, the magnification changes as the distance between the scope and object is varied. Changes in magnification make it impossible to measure surface distances for staging of lesion or to determine the displacement of structures. The objective of this invention is to develop a new device that provides a simple and noninvasive method of measuring accurate lesion size through an endoscope. METHODS: The invention incorporates a built-in laser diode that projects auto-parallel beams into the optical path of the rigid laryngoscope to form 2 spots in the field of view. RESULTS: The interspot distance is constant despite changes in focal plane, magnification, or viewing angle of laryngoscope. The interspot distance of being projected to even surface is constantly 4 mm. CONCLUSIONS: This device enables the laryngologist to easily measure the distance between landmarks, or the size of vocal fold lesions in the outpatient setting. S189 – Tracheotomy Tube Occlusion Status and Swallowing Function Joseph J Donzelli, MD (presenter); Susan L Brady, MS; Scott M Kaszuba, MD; Michele W Wesling OBJECTIVES: To compare the effects, if any, various types of tracheotomy occlusion conditions may have upon swallowing during either the videofluoroscopic swallow study (VFSS) or fiberoptic endoscopic exam of the swallow (FEES). METHODS: Prospective, repeated measure design. Patients underwent randomized order of tracheotomy occlusion conditions (open, finger, one-way valve, capped) during selected swallows. Main outcome measures were the presence or absence of aspiration/laryngeal penetration. RESULTS: 39 participants have completed the protocol, 19 males/20 females, mean age of 59.41 years (SD⫽19.31). 20 underwent the VFSS and 19 underwent FEES. The majority of participants (58.9%, 28/39) were able to safely swallow without any airway invasion under all occlusion conditions. Change in swallow function under 1 or more of the occlusion conditions was present in 25.6% (10/39) of the participants. 4 subjects had increased airway invasion with no occlusion (open), 4 with finger occlusion, and 2 while capped. One subject had less airway invasion with the 1-way valve as compared to the other conditions. One subject aspirated under all occlusion conditions. CONCLUSIONS: No clear patterns for optimal occlusion

P139 condition for swallowing were identified. Results of this study suggest that swallowing disorders in patients with a tracheotomy tube is a multifactiorial problem and several factors may be associated with the swallowing dysfunction. Therefore, patients should be evaluated under various occlusion conditions to determine their specific optimal swallowing condition. S190 – Voice Spectral Analysis After Surface Electrical Stimulation Edie Renee Hapner, PhD (presenter); Mary Gorham-Rowan, MD; Richard J. Morris, PhD; Linda P Fowler, PhD OBJECTIVES: The purpose of this study was to measure changes in vocal fold closure associated with surface electrical stimulation (VitalStim®). METHODS: 30 participants, 15 male and 15 female, ages 20-56 years, were included in the study. Participants underwent 1 hour of surface electrical stimulation, per guidelines reported in the VitalStim® manual. 3 trials of the vowel /ae/ were analyzed pre- and post-stimulation. Indirect estimates of glottal closure were obtained from the recorded vowels, as follows: 1) H1-H2: the amplitude of the first harmonic to the second harmonic (open quotient); 2) H1-A1: the ratio of the amplitude of the first harmonic to the amplitude of the first formant (glottal width); and 3) H1-A3: the ratio of the amplitude of the first harmonic to the amplitude of the third formant (spectral tilt). RESULTS: The direction and magnitude of change for all 3 parameters varied widely across participants. No significant difference occurred pre- vs. post-stimulation for any of the parameters. CONCLUSIONS: VitalStim® did not systematically affect open quotient, glottal width, or spectral tilt. These results do not support the concept that VitalStim® has a direct effect upon vocal fold closure. S191 – Unilateral Vocal Fold Paralysis: Medialization Results Donna Lundy, PhD (presenter); Roy R Casiano, MD; Mario Alberto Landera, MA; Michael Bublik, MD OBJECTIVES: Management of glottal insufficiency due to unilateral vocal fold paralysis (UVFP) has evolved from transoral injection to external thyroplasty to revisited injections (transoral or transcutaneous). Currently, preference is given to the less invasive injection medialization. Multiple injectable materials have been utilized with newer ones being introduced to manage concerns over permanency and vocal fold vibratory patterns. The purpose of this study is to evaluate the long-term results of injection medialization for UVFP in terms of stability of glottal closure and voice outcome vs. need for reinjection. METHODS: All patients with UVFP that underwent injection

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