phonotraumatic lesions

Summary: As the field of laryngology continues to grow and develop, practitioners will continue to have safer and more effective treatment options, both in the operating suite and in the clinic setting, for management of phonotraumatic lesions. Phonotraumatic vocal hyperfunction (PVH) is associated with chronic misuse and/or abuse of voice that can result in lesions such as vocal fold nodules. The LPR patients selected were precluded for having vocal fold hyperplastic lesions by our basis of selection, but hard voice onset is one of the main causes of vocal fold hyperplastic lesions. phonotrauma: Any abuse or misuse of the vocal cords (folds), more commonly seen in those with professional voices, which gives rises to various lesions (e.g., polyps, nodules, degenerative polyps, cysts, varices, papillomas) and other benign conditions. Find Dr. Burns's phone number, address, insurance information, hospital affiliations and more. 2020 Feb 26;63(2):372-384. doi: 10.1044/2019_JSLHR-19-00065. Dr. Tiffiny A. Hron is an ENT-otolaryngologist in Norwood, Massachusetts and is affiliated with Massachusetts General Hospital. susceptible to phonotraumatic lesions including nodules, cyst and polyp. Phonotraumatic vocal hyperfunction (PVH) is associated with chronic misuse and/or abuse of voice that can result in lesions such as vocal fold nodules. Differences in Weeklong Ambulatory Vocal Behavior Between Female Patients With Phonotraumatic Lesions and Matched Controls. Jarrad H. Van Stan, Daryush D. Mehta, Andrew J. Ortiz, James A. Burns, Laura E. Toles, Katherine L. Marks, Mark Vangel, Tiffiny Hron, Steven Zeitels; and ; Robert E. Hillman Vocal Fold Nodule. Uniform and log-normal probability distributions were fitted to the time to recurrence curves for vocal fold polyps, midfold masses . Average ambulatory measures of sound pressure level, fundamental frequency, and vocal dose do not differ between adult females with phonotraumatic lesions and matched control subjects. Introduction: The human vocal folds undergo a tremendous amount of soft tissue trauma. to phonotraumatic lesions including nodules, cyst and polyp. Tsui et al found that patients with benign phonotraumatic lesions (vocal nodules, polyps, and cysts) were predominantly younger, and patients with glottic neoplasms were older. Patients with growths on their vocal cords, like cancer or papilloma, can benefit from surgery as well, often through procedures that use advanced pulsed laser technologies to help preserve voice. Benign Phonotraumatic Lesions There are many different causes of hoarseness resulting in a change in the voice. Ultimately, he published his work in 1972, introducing an endoscopic delivery system for the CO 2 laser [ 29 ]. In particular, there has been an increased emphasis on techniques for in-office management of lesions. Voice Handicap Index-10 (VHI-10) scores, video and audioperceptual analyses, acoustic and aerodynamic analyses at baseline, and patient . More refined characterizations of underlying phonatory mechanisms and other potentially contributing causes are warranted to better understand ris … Although all patients had phonotraumatic lesions, only three of five females, and four of seven males reported abnormal VHI-10 scores despite complaining of dysphonia as their primary reason for the clinic visit. 2019: 1 month and 6 months: GRBAS, VHI, Jitter, Shimmer, NHR: Statistically significant pre/post scores Differences in Weeklong Ambulatory Vocal Behavior Between Female Patients With Phonotraumatic Lesions and Matched Controls J Speech Lang Hear Res . Study Design/Methods—A total of 123 dysphonic individuals with benign vocal pathologies were recruited. Thirty-six patients undergoing voice therapy for the treatment of phonotraumatic vocal fold lesions randomly received either a 4-day course of oral steroids or a placebo prior to initiating voice therapy. Exclusion criteria included recent use of any glucocorticoids (oral, inhaled, or intravenous) in the prior three months, presence of significant neurological impairment . Dr. James A. Burns is a ENT-Otolaryngologist in Boston, MA. These lesions arise from an acute event and can persist with varying degrees of hoarseness and impact on the individual's occupation, produc-tivity and social interactions. Pseudocysts and midfold fibrous masses are chronic lesions predominantly found in young women that recur with log-normal distribution over time, suggesting gradual . Some of the most common causes include non-cancerous (benign) vocal cord growths and swelling, also known as phonotraumatic lesions. They can also form from more prolonged voice over-use over many months. it is believed that phonotraumatic lesions are caused by or associated with aberrant vocal behavior in daily life, such as phonating at inappropriate fundamental frequencies ( f o ), producing excessive vocal intensity/sound pressure level (spl), voicing too often without adequate rest, and/or phonating inefficiently (e.g., voicing produced with … Precancerous lesions: Removing precancerous lesions on the vocal cords can help reduce the risk of cancer. Benign vocal fold lesions are commonly attributed to episodes of phonotrauma resulting in focal vocal fold tissue damage and while the genesis of these lesions is not yet fully established, phonotraumatic benign vocal fold lesions generally include nodules, polyps, pseudocysts and reactive lesions.10, 11, 12 The long-term responsiveness of . 5 Like vocal fold nodules, they are phonotraumatic lesions, but, unlike vocal fold nodules, they typically occur from episodes of intense phonotrauma or from a single vocally abusive event, such as screaming at a concert. Phonotraumatic lesions: Common in singers and other voice professionals, these include cysts, nodules (nodes), and polyps; Precancerous lesions: Removing these lesions to prevent throat cancer can affect the sound of your voice; Vocal cord paralysis: Stemming from cancer, nerve damage, infections, and many other causes Males and females between 18 and 80 with phonotraumatic lesions deemed causative of dysphonia were included if voice therapy was determined as the initial treatment modality. Phonotrauma can cause a variety of benign epithelial and lamina propria abnormalities, including vocal nodules, vocal polyps, and vocal cysts. In addition, LPR occurs in 75% of patients with vocal polyps. The histology and behavior of glottic keratosis can be frustratingly difficult to predict, as lesions can present on a spectrum anywhere from completely . Phonotraumatic lesions generally produce a series of sequelae including hoarseness, vocal fatigue, and compromise of high-frequency phonation (Verdolini et al., in press;). Jarrad H. Van Stan, Daryush D. Mehta, Andrew J. Ortiz, James A. Burns, Laura E. Toles, Katherine L. Marks, Mark Vangel, Tiffiny Hron, Steven Zeitels; and ; Robert E. Hillman Examples of phonotraumatic lesions include: Vocal cord nodules - A collection of stiff tissue under the epithelium of the vocal cords; Vocal cord polyp - A soft blister of the vocal cord, usually on one side that may have recurrent bleeding ; Vocal cord cyst - a lesion deeper in the vocal fold that may be related to phonotrauma or congenital There is evidence that singers should recover for a As part of that work I am specifically interested in laryngeal tension and its potential role in the development of phonotraumatic lesions, muscle tension dysphonia, and people's perceptions of vocal effort in their daily lives. Vocal fold polyps are acute lesions evenly distributed by age and gender that recur uniformly over time, suggesting they arise from sudden tissue reactions to phonotraumatic stress. As such, they are susceptible to phonotraumatic lesions including nodules, cyst and polyp. Keratosis may be associated with phonotraumatic lesions, and these generally have low malignant potential. STUDY DESIGN:Retrospective review. These lesions are considered phonotraumatic lesions. Study design: Retrospective review. Fig. Clinical management of phonotraumatic vocal fold lesions (nodules, polyps) is based largely on assumptions that abnormalities in habitual levels of sound pressure level (SPL), fundamental . Patients in the group of lesions unrelated to phonotrauma showed a longer period of therapy. In addition to paradoxical vocal fold motion, other conditions in the larynx such as idiopathic subglottic stenosis and phonotraumatic lesions (benign vocal fold lesions associated with voice use) are also more common in women. 1 Phonotraumatic lesions (a), and lesions unrelated to phono- trauma (b). METHODS:Records of adults who underwent microlaryngoscopy between 2006 and 2017 for vocal fold cysts, midfold masses, polyps, pseudocysts, sulcus vocalis (Ford type 3), and varices were . For many, with removal of the lesions (nodules, polyps, pseudocysts, and granulomas), the problem was solved, and speech therapy was in charge of the postoperative functional rehabilitation care. Purpose: The purpose of this study was to describe a typical clinical course and to provide acoustic, aerodynamic, auditory-perceptual, and stroboscopic assessment of a patient with bilateral mid-membranous vocal fold lesions. A vocal cord polyp (blister) usually occurs on one vocal cord. Several laboratory and modeling studies have demonstrated that patients with phonotraumatic lesions seem to employ phonatory adjustments that maintain vocal SPL at the expense of increased potential for vocal fold trauma (e.g., elevated airflow and subglottal pressure metrics; Espinoza et al., 2017; Hillman et al., 1989; Zañartu et al., 2014). Dr. Steven M. Zeitels is an ENT-otolaryngologist in Boston, Massachusetts and is affiliated with multiple hospitals in the area, including Massachusetts Eye and Ear Hospital and Massachusetts . The number of sessions and the functional result after speech therapy were evaluated. Treatment. phonotraumatic lesions and those with lesions unrelated to phonotrauma ( Table 1) Speech therapy resulted in optimal evolution in 92.37% of cases with phonotraumatic lesions as well as 70.13% of cases Thus, the status for such patients is described in the framework as "Modified vocal function" and is purposely positioned between the PVH and Normal vocal function blocks of the framework. Patients in the group of lesions unrelated to phonotrauma. Objective—To investigate the effectiveness of acupuncture in treating phonotraumatic vocal fold lesions. Differences in weeklong ambulatory vocal behavior between female patients with phonotraumatic lesions and matched controls Jarrad H. Van Stan, Daryush D. Mehta, Andrew J. Ortiz, James A. Burns, Laura E. Toles , Katherine L. Marks, Mark Vangel, Tiffiny Hron, Steven Zeitels, Robert E. Hillman Achieving precise phonomicrosurgical resection in conjunction with Either way, the lesion creates incomplete closure of the vocal cords and alters the surface Purpose: The purpose of this study was to describe a typical clinical course and to provide acoustic, aerodynamic, auditory-perceptual, and stroboscopic assessment of a patient with bilateral mid-membranous vocal fold lesions. Results Five hundred ten adults (223 male:287 female; mean age 40.3 ± 14.9 years) were included. Average ambulatory measures of sound pressure level, fundamental frequency, and vocal dose do not differ between adult females with phonotraumatic lesions and matched control subjects. Purpose: Our goal was to test prevailing assumptions about the underlying biomechanical and aeroacoustic mechanisms associated with phonotraumatic lesions of the vocal folds using a numerical lumped-element model of voice production. 34 Therefore, the incidence of hard voice onset in LPR patients might be underestimated . Methods This study was performed at IPO Hospital (Paranaense Institute of Otorhi-. Phonotrauma can manifest a number of different ways: Vocal nodules (callouses) are superficial lesions on the lining of the vocal cords and usually occur in the middle of both vocal folds. "Perspectives on Phonotraumatic Lesions: ENT and SLP Perspective" A comprehensive webinar by two astounding personalities from the field of Otolaryngology and Speech Language Pathology Dr. Nupur Nerurkar Laryngologist from Bombay Hospital, fellow of the American Broncho-Esophagological Association as well as the American Laryngological Association and […] Objectives: Clinical management of phonotraumatic vocal fold lesions (nodules, polyps) is based largely on assumptions that abnormalities in habitual levels of sound pressure level (SPL), fundamental frequency (f0), and/or amount of voice use play a major role in lesion development and chronic persistence. Annals of Otology, Rhinology & Laryngology, 124(11), 864-874. Patients operated for nonphonotraumatic lesions (e.g., granuloma, keratosis/leukoplakia, papilloma) were excluded. Change in measures of vocal function was observed in female speakers with PVFLs immediately following a 30 minutes targeted exercises protocol. development of phonotraumatic lesions20,21 and the compromise of vocal fold epithelial structures.22 However, there is a lack of agreement in the literature about the association between average vocal intensity and the development and/or presence of vocal fold lesions. Methods: Medical records and stroboscopic exams of adults who underwent microlaryngoscopic resection of phonotraumatic vocal fold lesions over a 13-year period were reviewed for time to recurrence after surgery. Lesion type distribution was analyzed with respect to sex, age, singer classification, and voice training. Of 254 patients who underwent laryngeal microsurgery, 208 patients were included in the study and divided in two groups: group A with phonotraumatic lesions (n = 131) and group B with lesions unrelated to phonotrauma (n = 77). These lesions arise from an acute event and can persist with varying degrees of hoarseness and impact on the individual's occupation, productivity and social . Objectives: To determine recurrence rates for benign phonotraumatic vocal fold lesions after microlaryngoscopic surgery. Europe PMC is an archive of life sciences journal literature. She received her medical degree from Boston University School of . Patients with phonotraumatic lesions such as nodules, polyps and cysts can benefit from voice therapy and also surgery. The clinical aerodynamic assessment of vocal function has been recently shown to differentiate between patients with

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