Longitudinal Analysis of Dysphagia and Factors Related to Postoperative Pneumonia in Patients Undergoing Esophagectomy for Esophageal Cancer.

Few studies have quantified longitudinal changes in swallowing in patients undergoing esophagectomy for esophageal cancer. This study longitudinally analyzed the changes in the Modified Barium Swallow Study Impairment Profile (MBSImP™) scores, swallowing kinematic measurements, and swallowing-related symptoms in patients undergoing esophagectomy. We also examined the association between identified swallowing impairment and aspiration pneumonia after surgery.

Aspiration Prevention Surgery: Clinical Factors Associated With Improvements in Oral Status Intake and Suction Frequency.

Objective: In recent years, the use of aspiration prevention surgery (APS) for the treatment of severe dysphagia has been on the rise. However, relevant clinical studies have included small samples, and the frequency of, and risk factors for postoperative complications have not been clarified. We investigated the clinical features of patients undergoing APS and whether oral-intake status and suction frequency could be reduced.

Sex-and Age-Based Etiological Analysis of 2901 Patients With Dysphonia in a Japanese Tertiary Medical Institute.

Objectives: Societal aging is a grave concern in Japan, and its impact on voice clinics has not been investigated. This study aimed to clarify recent demographic features of geriatric dysphonia at a tertiary medical institute in Japan.

Study Design: Retrospective study.

Sex and Age Stratified Voice Data in Japanese Vocally Healthy Individuals: Vocal Capacity.

Objective: There is no normative voice dataset regarding the vocal capacity of Japanese speakers in the English literature. We collected age- and sex-stratified data on the vocal capacity of vocally healthy Japanese speakers.

Methods: In total, 111 vocally healthy Japanese speakers (42 men and 69 women) were divided into the young (13 men and 30 women), middle-aged (18 men and 27 women), and elderly (11 men and 12 women) groups.

Swallowing computed tomography and virtual reality as novel imaging modalities for the diagnosis of clicking larynx: Two case reports.

Globus sensation and pain causes are difficult to identify by conventional examination methods. With technology advances, new imaging methods including swallowing computed tomography (CT) and virtual reality (VR) have emerged and are contributing to definite diagnoses. We report two cases of cervical discomfort diagnosed as clicking larynx using swallowing CT/VR .

Gender- and Age- Stratified Normative Voice Data in Japanese-Speaking Subjects: Analysis of Sustained Habitual Phonations.

Introduction: There is no normative voice dataset for Japanese speakers in the English literature. We constructed age- and gender-stratified normative voice data with the assistance of vocally healthy Japanese speakers.

Methods: A total of 111 vocally healthy Japanese speakers (42 men, 69 women) were divided into young (13 men, 30 women), middle-aged (18 men, 27 women), and elderly (11 men, 12 women) groups.

Effects of Aspiration Prevention Surgery on the Dynamics of the Pharynx and Upper Esophageal Sphincter.

Objective: Oral intake after aspiration prevention surgery (APS) is influenced by postoperative pharyngeal pressure and the dynamics of the upper esophageal sphincter (UES). We examined the effects of less invasive APS combined with UES relaxation techniques (laryngeal closure with cricopharyngeal myotomy [LC-CPM] and central-part laryngectomy [CPL]) on pharyngeal pressure and UES dynamics.

Study Design: Retrospective, observational study.

Risk Factors for Aspiration Pneumonia After Receiving Liquid-Thickening Recommendations.

Objective: We examined the influence of liquid thickness levels on the frequency of liquid penetration-aspiration in patients with dysphagia and evaluated the clinical risk factors for penetration-aspiration and aspiration pneumonia development.

Study Design: A case series.

Setting: Single-institution academic center.

Safety of surgical tracheostomy under continued antithrombotic therapy: A retrospective cohort study.

Objective: Although various guidelines have been established for the management of antithrombotic therapy during surgical treatments, surgical tracheostomy (ST) under continued antithrombotic therapy (CAT) remains challenging. Here, we investigated the risk factors for complications after ST by focusing on the application of CAT during ST.

Design: A retrospective cohort study with medical records from 2009 to 2020.

Multivariate Analysis of Vocal Fold Vibrations in Normal Speakers Using High-Speed Digital Imaging.

Introduction: Little is known about the normal variations in vocal fold vibrations. We conducted a prospective study on normal subjects using high-speed digital imaging (HSDI) to elucidate key parameters regarding age/gender-related normal variations.

Methods: Forty-six healthy adult volunteers were divided into young (aged ≤35 years) male, young female, elderly (aged ≥65 years) male, and elderly female subgroups.

Expression of ACE2 and TMPRSS2 Proteins in the Upper and Lower Aerodigestive Tracts of Rats: Implications on COVID 19 Infections.

Objective: Patients with coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), exhibit not only respiratory symptoms but also symptoms of chemo-sensitive disorders. Cellular entry of SARS-CoV-2 depends on the binding of its spike protein to a cellular receptor named angiotensin-converting enzyme 2 (ACE2), and the subsequent spike protein-priming by host cell proteases, including transmembrane protease serine 2 (TMPRSS2). Thus, high expression of ACE2 and TMPRSS2 is considered to enhance the invading capacity of SARS-CoV-2.

Esophageal Dysmotility is Common in Patients With Multiple System Atrophy.

Objectives: Esophageal dysmotility (ED) in patients with multiple system atrophy (MSA) are poorly understood. This study aimed to investigate the prevalence of ED in patients with MSA and to assess the relationship of esophageal abnormalities with other clinical findings and characteristics in these patients.

Methods: A retrospective chart review was conducted to identify patients with MSA and to compare them to the elderly controls without MSA (65+ years) who underwent a videofluorographic esophagram from 2014 to 2019.

Choice of Aspiration Prevention Surgery for Patients With Neuromuscular Disorders: Report of Three Cases.

Dysphagia, one of the major complications of neuromuscular diseases such as Parkinson's disease and amyotrophic lateral sclerosis (ALS), decreases quality of life and may lead to malnutrition or aspiration pneumonia. Although recent reports have suggested that surgical aspiration prevention improves quality of life and enables oral intake, the selection of appropriate aspiration prevention techniques has rarely been discussed. In this report, we present the cases of three patients with neuromuscular diseases who underwent surgical aspiration prevention; we selected the surgical techniques based on analysis of the dysphagia mechanisms, disease progression, and general condition in each case.

The effects of barium concentration levels on the pulmonary inflammatory response in a rat model of aspiration.

Purpose: Barium sulfate (Ba) suspension is the most widely used contrast agent for upper gastrointestinal and videofluoroscopic swallow studies (VFSS). The effect of Ba concentration on lung injury is uncertain. The aims of this study were to explore the effects of different barium concentrations on the respiratory organs and elucidate the underlying mechanisms of these effects in an established animal model of aspiration.

Unilateral vocal fold adductor paralysis after tracheal intubation.

Vocal fold immobility is a relatively rare complication that can occur after tracheal intubation. Differential diagnoses include a rare clinical entity called unilateral vocal fold adductor paralysis in which only branches entering the thyroarytenoid and lateral cricoarytenoid muscles of the recurrent laryngeal nerve become paralyzed. Computed tomography and laryngeal electromyography are required to distinguish this condition from others such as cricoarytenoid dislocation/subluxation.

Characterization of Vocal Fold Vibration in Sulcus Vocalis Using High-Speed Digital Imaging.

Purpose: The aim of the present study was to qualitatively and quantitatively characterize vocal fold vibrations in sulcus vocalis by high-speed digital imaging (HSDI) and to clarify the correlations between HSDI-derived parameters and traditional vocal parameters.

Method: HSDI was performed in 20 vocally healthy subjects (8 men and 12 women) and 41 patients with sulcus vocalis (33 men and 8 women). Then HSDI data were evaluated by assessing the visual-perceptual rating, digital kymography, and glottal area waveform.

High-speed Videolaryngoscopy: Quantitative Parameters of Glottal Area Waveforms and High-speed Kymography in Healthy Individuals.

Objectives: We conducted a study to obtain quantitative parameters of the vocal dynamic using high-speed videolaryngoscopy and to characterize the vocal fold vibration pattern of healthy individuals by analyzing glottal area waveforms and high-speed kymography.

Methods: Laryngeal images of 45 healthy individuals were captured using high-speed videolaryngoscopy. The open and speed quotients of the glottal area waveforms and high-speed kymography were obtained and statistically analyzed according to the gender of each individual.

Quantitative Analysis of Vocal Fold Vibration in Vocal Fold Paralysis With the Use of High-speed Digital Imaging.

Introduction: The goal of this work was to objectively elucidate the vibratory characteristics of vocal fold paralysis (VFP) using high-speed digital imaging (HSDI).

Methods: HSDI was performed in 29 vocally healthy subjects (12 women and 17 men) and in 107 patients with VFP (40 women and 67 men). Then, the HSDI data were evaluated by visual-perceptual rating, single-line kymography, multiline kymography, laryngotopography, and glottal area waveform analysis.

Visualization and Estimation of Vibratory Disturbance in Vocal Fold Scar Using High-Speed Digital Imaging.

Objective: To explore the method to visualize and quantify the abnormality of vocal fold vibration in vocal fold scar (VFS) using high-speed digital imaging (HSDI).

Methods: HSDI was performed on 12 patients (2 men and 10 women) with VFS and 46 vocally healthy subjects (17 men and 29 women), and the obtained data were quantitatively evaluated by frame-by-frame analysis, laryngotopography (LTG), single-line and multiline kymography, and glottal area waveform.

Results: Visualization of a scarred area was feasible in 75% of VFS in the present study using LTG.

Supra-thyroid alar cartilage approach for the complete resection of laryngeal submucosal tumors and postoperative voice quality.

Various surgical approaches for the treatment of laryngeal submucosal tumors have been reported. Endoscopic excision is indicated for small lesions, while external approaches are recommended for larger tumors. This report introduces a supra-thyroid alar cartilage approach (STACA), which has strong advantages for the preservation of the laryngeal framework and voice recovery after surgery.

Quantification of Vocal Fold Vibration in Various Laryngeal Disorders Using High-Speed Digital Imaging.

Objective: To quantify vibratory characteristics of various laryngeal disorders seen by high-speed digital imaging (HSDI).

Methods: HSDI was performed on 78 patients with various laryngeal disorders (20 with polyp, 16 with carcinoma, 13 with leukoplakia, 6 with vocal fold nodule, and 33 with others) and 29 vocally healthy subjects. Obtained data were quantitatively evaluated by frame-by-frame analysis, laryngotopography, digital kymography, and glottal area waveform.

Relationship of Various Open Quotients With Acoustic Property, Phonation Types, Fundamental Frequency, and Intensity.

Introduction: In the present study, we examined the relationship between various open quotients (Oqs) and phonation types, fundamental frequency (F0), and intensity by multivariate linear regression analysis (MVA) to determine which Oq best reflects vocal fold vibratory characteristics.

Methods: Using high-speed digital imaging (HSDI), a sustained vowel /e/ at different phonation types, F0s, and intensities was recorded from six vocally healthy male volunteers: the types of phonation included modal, falsetto, modal breathy, and modal pressed phonations; and each phonation was performed at different F0s and intensities. Electroglottography (EGG) and sound signals were simultaneously recorded with HSDI.

An Aerodynamic Study of Phonations in Patients With Parkinson Disease (PD).

Background: The precise comparison of the voice characteristics of Parkinson disease (PD) patients with age-matched normal subjects is still one of the important research projects. The present study aimed at comparing the voice characteristics in sustained phonations of PD patients with an age-matched control group.

Methods: The subjects were 30 Japanese PD patients (15 males and 15 females).

Vocal Fold Vibration in Vocal Fold Atrophy: Quantitative Analysis With High-Speed Digital Imaging.

Introduction: Vocal fold vibrations of vocal fold atrophy (VFA), a rapidly increasing voice disorder owing to worldwide societal aging, have not been clarified by high-speed digital imaging (HSDI).

Methods: The HSDI method was performed on 46 patients (33 males and 13 females) with VFA and 20 vocally healthy subjects (8 males and 12 females), and the obtained data were quantitatively evaluated by frame-by-frame analysis, laryngotopography, single- and multi-line kymography, and glottal area waveform.

Results: Overall, patients with VFA revealed larger open quotients, larger lateral phase difference, larger integral glottal width (the average glottal width over a glottal cycle), and smaller speed index than vocally healthy subjects.