Vocal fold scarring disrupts the viscoelastic properties of lamina propria that are critical for normal phonation. There is a clinical need development advanced biomaterials approximate mechanical in vivo vocal regeneration. We have developed hyaluronic acid (HA)-based microgels and cross-linked microgel networks with tunable degradation properties. HA were prepared by cross-linking derivatives carrying hydrazide (HAADH) aldehyde (HAALD) functionalities within inverse emulsion droplets....

Objectives: Treatment of glottal papillomatosis and dysplasia was mirror-guided done in surgeons' offices the 19th century. It migrated to operating room 20th century accommodate direct laryngoscopic surgery, which required assistants administer anesthesia procedural support. The primary treatment goals, are disease regression voice restoration and/or maintenance, tempered by morbidity general potential treatment-induced vocal deterioration. To obviate anesthesia, office-based laser...

Abstract Objectives: To evaluate whether the timing of early (≤6 months from time nerve injury) vs. late (>6 months) injection medialization laryngoplasty impacts need for subsequent open‐neck reconstruction to restore vocal function in patients with unilateral cord paralysis. Study Design: Retrospective chart review. Methods: A total 112 outpatient or hospitalized adults dysphonia resulting postsurgical idiopathic paralysis were identified who injected as initial treatment within 1 year...

Phonomicrosurgical treatment of premalignant vocal fold epithelium and microinvasive cancer combines principles surgical oncology with advanced laryngoscopic microsurgical-techniques. This is guided by mucosal-wave theory voice production strives not only to cure the disease but also achieve optimal function. Surgical techniques developed during past two centuries have improved methods for visualization, tissue retrieval, evaluation. Examination evolution these reveals incomplete convergence...

Despite a well-recognized clinical need for material to replace missing or damaged vibratory connective tissue of the vocal fold, materials have yet be engineered specifically this purpose. Injectable hydrogels are particularly attractive because they would require minimally invasive surgical procedure, could fill irregular defects, and designed viscoelastic properties similar normal tissue. We therefore synthesized series photo-cross-linkable using hyaluronic acid (HA) as starting material....

Ultrafast pulsed lasers can be used to achieve remarkable precision during surgical ablation. Through nonlinear interactions with tissue, ultrafast provide a largely non-thermal mechanism of ablation and unique ability create targeted damage within bulk tissue. These advantages have made the ideal tool for various novel applications in ophthalmology. Clinical adoption other remains limited part due lack means fiber delivery laser pulses as flexible, hand-held endoscope. This review provides...

Objectives: Photoangiolytic laser treatment of recurrent respiratory papillomatosis (RRP) is effective, but does not reliably prevent recurrence. Therefore, sublesional injections the antiangiogenic agent bevacizumab (Avastin) were given to assess adjunctive effect on disease Since a new therapeutic modality for RRP, there also primary safety objectives determine whether was negative impact voice and local or systemic complications. Methods: A prospective open-label investigation conducted...

Treatment of glottal papillomatosis and dysplasia was mirror-guided performed in surgeons' offices the 19th century. It migrated to operating room 20th century accommodate direct laryngoscopic surgery, which required assistants administer anesthesia procedural support. Presently, primary treatment goals, are disease regression voice restoration or maintenance, tempered by morbidity general potential treatment-induced vocal deterioration. In fact, has been appropriately considered be an...

Phonomicrosurgery in performing artists has historically been approached with great trepidation, and vocal outcome data are sparse. The liability of surgically disturbing the superficial lamina propria (SLP) epithelium must be balanced inherent detrimental effect lesion(s). A prospective investigation was performed on 185 who underwent phonomicrosurgical resection 365 lesions: 201 nodules, 71 polyps, 66 varices ectasias, 13 cysts, 8 keratotic lesions, 2 granulomas, Reinke's edema,...

Abstract Transoral excision of supraglottic and hypopharynx cancer as a single modality is effective when lesions are selected for small size endoscopic accessibility. Excisional biopsy with clear margins larger tumors in combination postoperative radiotherapy provides an excellent treatment alternative patients who not candidates open surgery. In this preliminary report, 45 cases using minimally invasive approach reviewed outlining oncologic rationale functional advantages. A large bore...

Varices and ectasias in singers are typically the result of phonotraumatic shearing stresses and/or collision forces on microcirculation within superficial lamina propria. These lesions can be debilitating performing vocalists because effect recurrent hemorrhage as a contributing factor to morbidity other mass such polyps, nodules, cysts. Phonomicrosurgical treatment performers is understandably approached with great trepidation, vocal liability surgically disturbing propria epithelium must...

Objectives: This study examines the elastic fiber and hyaluronic acid (HA) content of midmembranous vocal fold laminae propriae (LPs) humans, dogs, pigs, ferrets. Methods: Lamina propria elastin was quantified by measuring amino desmosine, HA measured an enzyme-linked immunosorbent assay-based technique. Quantitative histology used to evaluate levels in specific LP regions. The distributions fibrillin-1, a primary microfibrillar component fibers, tropoelastin, indicator synthesis, were...

Purpose Previous work using ambulatory voice recordings has shown no differences in average vocal behavior between patients with phonotraumatic hyperfunction and matched controls. This study used larger groups to replicate these results expanded the analysis include distributional characteristics of use measures indicative glottal closure. Method Subjects included 180 adult women: 90 diagnosed fold nodules or polyps age-, sex-, occupation-matched controls history disorders. Weeklong summary...

Reinke's edema (RE) has been associated typically with smoking and sometimes vocal abuse, but aspects of the pathophysiology RE remain unclear. To gain new insights into phonatory mechanisms pathophysiology, we used an integrated battery objective function tests to analyze 20 patients (19 women) who underwent phonomicrosurgical resection. Preoperative stroboscopic examinations demonstrated that superficial lamina propria is distended primarily on superior fold surface. Acoustically, these...

Objectives: This study examines the collagen content and turnover in midmembranous vocal fold laminae propriae (LPs) of humans, dogs, pigs, ferrets. Methods: The LP levels were assessed by quantifying tissue hydroxyproline. Quantitative histology allowed evaluation specific regions. Several types Two markers examined immunohistochemically. Results: Collagen made up 43.4% ± 2.6% human total protein (TP), with men having approximately 30% higher than women (p > .024). pigs (52.6% 1.9% TP)...

Recently developed systems for ambulatory monitoring of voice use employ miniature accelerometers placed at the base anterior neck to sense phonation. As it is hoped that such will help improve clinical assessment and management disorders, this study was undertaken determine impact dysphonia severity on accuracy accelerometer-based estimates vocal function.Simultaneous recordings were made oral acoustic (microphone) skin acceleration signals 6 normal speakers 18 patients with disorders (mild...

Phonosurgical management of early glottic cancer has evolved considerably, but objective vocal outcome data are sparse. A prospective clinical trial was done on 32 patients with unilateral (T1a in 28 and T2a 4) who underwent ultranarrow-margin resection; 15 had resection superficial to the ligament, 17 deep it. The subepithelial infusion technique facilitated selection these for appropriate procedure. All cancer-free without radiotherapy or open surgery. Involvement anterior commissure...

Since 1977, we have used induction chemotherapy (CT) plus radiation therapy (RT) with curative intent in 35 advanced head and neck cancer (Ca) patients who otherwise would required total laryngectomy. Fourteen had Ca of the larynx or supraglottic (SGL); 21 hypopharynx. In six. was Stage III; 26 it IV. Three II disease—2 pyriform sinus one patient SGL refused surgery. Chemotherapy consisted platinum (P) + bleomycin 18 until 1982, then P fluorouracil next 17 patients. Total response rate...

The 532 nm pulsed KTP (potassium titanyl phosphate) laser and the 585 dye (PDL) are photoangiolytic lasers that have been demonstrated to be effective for managing vocal fold dysplasia. putative mechanism of action is selective photoangiolysis sublesional microcirculation. On basis this experience, early glottic cancers were treated by selectively targeting intralesional microvasculature. This approach was derived from Folkman's concepts neoplastic growth resulting tumor angiogenesis. Staged...

Objectives: Although near-normal conversational voices can be achieved with the phonosurgical management of early glottic cancer, there are still acoustic and aerodynamic deficits in vocal function that must better understood to help further optimize interventions. Stroboscopic assessment is inadequate for this purpose. Methods: A newly developed color high-speed videoendoscopy (HSV) system included time-synchronized recordings signal was used perform a detailed examination voice production...