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SP259 – Vocal fold paresis and thyroid disease
P178
Otolaryngology-Head and Neck Surgery, Vol 141, No 3S1, September 2009
SP259 – Vocal fold paresis and thyroid disease Shruti S Joglekar, MD (presenter); Robert Sataloff, MD, DMA; Yolanda Heman-Ackah Beausoleil, MD; Reena Gupta, MD OBJECTIVES: The etiology of vocal fold paresis is multifactorial and remains unknown in most individuals. The purpose of this study is to evaluate the prevalence of thyroid disease in patients with a primary complaint of dysphonia and diagnosis of vocal fold paresis in comparison with the prevalence in a similar cohort of patients without dysphonia or vocal fold paresis. METHODS: Charts of 100 patients with dysphonia and vocal fold paresis (unilateral, bilateral; superior, and/or recurrent laryngeal nerve involvement) were reviewed. The diagnosis of paresis was made by senior consultants using videostroboscopy and was confirmed by laryngeal EMG. Thyroid disease was defined as abnormality in levels of thyroid hormones, thyroid antibody titers, or thyroid pathology on ultrasonography or CT/MRI of the neck. The prevalence of thyroid disease was compared with that in 100 patients with sensorineural hearing loss. Patients with both sensorineural hearing loss and vocal fold paresis were excluded from the study, as were patients with history of thyroid surgery. RESULTS: Fifty-four patients with vocal fold paresis had evidence of thyroid disease, while only 18 patients from control group had thyroid disease, p ⬍ 0.0001 (Chi-Squared). Thyroid diagnoses included benign growths in thyroid (65%), hormone imbalance (20%), Hashimoto’s thyroiditis (9%), and thyroid cancer. CONCLUSIONS: Thyroid abnormalities are more prevalent in patients with dysphonia and vocal fold paresis compared to a matched cohort without laryngeal symptoms or paresis. The study suggests an association between benign, malignant, autoimmune, and metabolic diseases of thyroid, dysphonia, and vocal fold paresis. SP264 – Vocal fold vibration observed by low-cost high-speed imaging Kenichi Kaneko, MD (presenter); Haruo Takahashi, MD; Koichi Sakaguchi, MD; Masato Inoue, MD OBJECTIVES: 1) To establish a method to observe vocal fold vibration using a low-cost high-speed movie system from a consumer digital video camera. 2) To observe vibration of healthy or paralyzed vocal folds with this system. METHODS: We assembled the high-speed movie system from a consumer digital video camera (EXILIM PRO EX-F1, Casio Computer Co., LTD., Tokyo) and a conventional rigid laryngeal endoscope. The camera can take digital images at a frame rate of 1,200 images per second and be purchased for about $1,000 (US) in Japan. We examined the vocal folds of
healthy subjects and patients with hemilateral or bilateral vocal fold paralysis with our system. We analyzed the vocal fold vibration by slow playback of the movies and kymographic images constructed from the movie files with our original software. RESULTS: The vocal fold vibrations of healthy subjects showed regularity, symmetry, complete glottal closure, normal amplitude and normal mucosal waves. However, those of the subjects with vocal fold paralysis showed irregularity, asymmetry, incomplete glottal closure, abnormal amplitude and abnormal mucosal waves. When the position of the paralyzed vocal fold changed, vibration pattern of the fold also changed. CONCLUSIONS: Our system is very cost-effective and will be useful for a routine clinical examination of the vocal folds to find causes of hoarseness.
Otology/Neurotology SP336 – 3D finite element model for osteogenesis imperfecta Ken Hayashi, MD, PhD (presenter); Takuji Koike; Kaoru Ogawa, MD, PhD OBJECTIVES: To investigate the relationship between the stiffness of the osseous spiral lamina and the vibration modes of the basilar membrane in osteogenesis imperfecta. METHODS: In this study, the effect of the stiffness of the osseous spiral lamina on vibration of the basilar membrane was analyzed based on clinical data and using a 3D finite element (FE) model of the human cochlea. The FE model consists of the stapes, the stapedial annular ligament, the oval window, vestibule, lymph, basilar membrane, osseous spiral lamina, and the cochlear aqueduct. Young’s modulus of the osseous spiral lamina was changed from the value of compact bone to that of cartilage, and the vibration of the basilar membrane was calculated using CFD-ACE⫹software package (CFD Research Corporation). RESULTS: Even if the stiffness of the osseous spiral lamina decreased, the traversing waves were generated on the basilar membrane, and the maximum amplitude of the basilar membrane was not changed drastically. However, the position of the maximum shifted toward the basal part of the cochlea. When the stiffness of the osseous spiral lamina decreased to the same value of cartilage, the maximum was observed at the basal end of the basilar membrane without regard to the applied frequency, and the frequency selectivity of the basilar membrane was lost. CONCLUSIONS: Our results suggest that softening of the osseous spiral lamina affects the vibration mode of the basilar membrane, and in such a case, the frequency selectivity of the cochlea will be lost.
Words and degrees that may be missing from abstracts in this program are due to limitations in the submission process. Continuing improvements in that database are still in process, and a serious attempt has been made to correct missing content. For the latest information about the annual meeting, and to access the new Itinerary Planner for your visit, please go to: www.entnet.org/annual_meeting.
Otolaryngology-Head and Neck Surgery, Vol 141, No 3S1, September 2009
SP259 – Vocal fold paresis and thyroid disease Shruti S Joglekar, MD (presenter); Robert Sataloff, MD, DMA; Yolanda Heman-Ackah Beausoleil, MD; Reena Gupta, MD OBJECTIVES: The etiology of vocal fold paresis is multifactorial and remains unknown in most individuals. The purpose of this study is to evaluate the prevalence of thyroid disease in patients with a primary complaint of dysphonia and diagnosis of vocal fold paresis in comparison with the prevalence in a similar cohort of patients without dysphonia or vocal fold paresis. METHODS: Charts of 100 patients with dysphonia and vocal fold paresis (unilateral, bilateral; superior, and/or recurrent laryngeal nerve involvement) were reviewed. The diagnosis of paresis was made by senior consultants using videostroboscopy and was confirmed by laryngeal EMG. Thyroid disease was defined as abnormality in levels of thyroid hormones, thyroid antibody titers, or thyroid pathology on ultrasonography or CT/MRI of the neck. The prevalence of thyroid disease was compared with that in 100 patients with sensorineural hearing loss. Patients with both sensorineural hearing loss and vocal fold paresis were excluded from the study, as were patients with history of thyroid surgery. RESULTS: Fifty-four patients with vocal fold paresis had evidence of thyroid disease, while only 18 patients from control group had thyroid disease, p ⬍ 0.0001 (Chi-Squared). Thyroid diagnoses included benign growths in thyroid (65%), hormone imbalance (20%), Hashimoto’s thyroiditis (9%), and thyroid cancer. CONCLUSIONS: Thyroid abnormalities are more prevalent in patients with dysphonia and vocal fold paresis compared to a matched cohort without laryngeal symptoms or paresis. The study suggests an association between benign, malignant, autoimmune, and metabolic diseases of thyroid, dysphonia, and vocal fold paresis. SP264 – Vocal fold vibration observed by low-cost high-speed imaging Kenichi Kaneko, MD (presenter); Haruo Takahashi, MD; Koichi Sakaguchi, MD; Masato Inoue, MD OBJECTIVES: 1) To establish a method to observe vocal fold vibration using a low-cost high-speed movie system from a consumer digital video camera. 2) To observe vibration of healthy or paralyzed vocal folds with this system. METHODS: We assembled the high-speed movie system from a consumer digital video camera (EXILIM PRO EX-F1, Casio Computer Co., LTD., Tokyo) and a conventional rigid laryngeal endoscope. The camera can take digital images at a frame rate of 1,200 images per second and be purchased for about $1,000 (US) in Japan. We examined the vocal folds of
healthy subjects and patients with hemilateral or bilateral vocal fold paralysis with our system. We analyzed the vocal fold vibration by slow playback of the movies and kymographic images constructed from the movie files with our original software. RESULTS: The vocal fold vibrations of healthy subjects showed regularity, symmetry, complete glottal closure, normal amplitude and normal mucosal waves. However, those of the subjects with vocal fold paralysis showed irregularity, asymmetry, incomplete glottal closure, abnormal amplitude and abnormal mucosal waves. When the position of the paralyzed vocal fold changed, vibration pattern of the fold also changed. CONCLUSIONS: Our system is very cost-effective and will be useful for a routine clinical examination of the vocal folds to find causes of hoarseness.
Otology/Neurotology SP336 – 3D finite element model for osteogenesis imperfecta Ken Hayashi, MD, PhD (presenter); Takuji Koike; Kaoru Ogawa, MD, PhD OBJECTIVES: To investigate the relationship between the stiffness of the osseous spiral lamina and the vibration modes of the basilar membrane in osteogenesis imperfecta. METHODS: In this study, the effect of the stiffness of the osseous spiral lamina on vibration of the basilar membrane was analyzed based on clinical data and using a 3D finite element (FE) model of the human cochlea. The FE model consists of the stapes, the stapedial annular ligament, the oval window, vestibule, lymph, basilar membrane, osseous spiral lamina, and the cochlear aqueduct. Young’s modulus of the osseous spiral lamina was changed from the value of compact bone to that of cartilage, and the vibration of the basilar membrane was calculated using CFD-ACE⫹software package (CFD Research Corporation). RESULTS: Even if the stiffness of the osseous spiral lamina decreased, the traversing waves were generated on the basilar membrane, and the maximum amplitude of the basilar membrane was not changed drastically. However, the position of the maximum shifted toward the basal part of the cochlea. When the stiffness of the osseous spiral lamina decreased to the same value of cartilage, the maximum was observed at the basal end of the basilar membrane without regard to the applied frequency, and the frequency selectivity of the basilar membrane was lost. CONCLUSIONS: Our results suggest that softening of the osseous spiral lamina affects the vibration mode of the basilar membrane, and in such a case, the frequency selectivity of the cochlea will be lost.
Words and degrees that may be missing from abstracts in this program are due to limitations in the submission process. Continuing improvements in that database are still in process, and a serious attempt has been made to correct missing content. For the latest information about the annual meeting, and to access the new Itinerary Planner for your visit, please go to: www.entnet.org/annual_meeting.