Patients' Demographics and Risk Factors in Voice Disorders: An Umbrella Review of Systematic Reviews.

Objectives: This study aimed to provide a comprehensive overview of the systematic reviews that focus on the prevalence of voice disorders (VDs), associated risk factors, and the demographic characteristics of patients with dysphonia. An umbrella review was conducted to identify general research themes in voice literature that might guide future research initiatives and contribute to the classification of VDs as a worldwide health concern.

Study Design: Umbrella review of systematic reviews.

Adjustment of Health-Care Service Delivery Among Phoniatricians and ENT Specialists During the COVID-19 Pandemic, A UEP Survey.

Background: Applying measures that prioritize staff safety, while protecting patient safety and care, represents a challenge during the current pandemic. Many documents of recommendations toward safe practice have been developed for this purpose.

Objective: To assess adjustments that have been undertaken by phoniatricians and otolaryngologists in the delivery of health-care services during the pandemic in order to reduce staff exposure to COVID-19 and improve safety.

Rehearsal Sound Exposure and Choir Singers' Hearing: A Pilot Field Study.

Unlabelled: Exposure to high- and moderate-intensity sound is inevitable for professional singers during their working day, the majority of which is spent in rehearsal, preparing for a performance. The impact of self-produced sound exposure on singers' hearing within the rehearsal setting has not been examined.

Objectives: This original pilot field study investigates the feasibility of data collection and hypothesis testing of singers' hearing within the rehearsal environment.

'Malregulative' Rather Than 'Functional' Dysphonia: A New Etiological Terminology Framework for Phonation Disorders-A Position Paper by the Union of European Phoniatricians (UEP).

Practitioners in the field of voice are often faced with patients who are 'dysphonic', but who do not have identifiable abnormalities of the vocal tract structures or any neural or hormonal alteration affecting the phonatory function. For lack of better nomenclature describing the origin of the disorder, this group of patients has been labeled as having 'non-organic' or 'functional' dysphonia. 'Non-organic' only states what the dysphonia is not, and 'functional' does not have any etiological implication.

Assessment and Management of Preoperative Anxiety.

Background: Preoperative anxiety has the potential to alter the dynamics of an elective procedure and has been shown to detrimentally affect patients both cognitively and physiologically. If mismanaged, it can lead to essential procedures being postponed or canceled, delay postoperative recovery, and increase patients' requirements for medical intervention postoperatively. These outcomes have harmful implications both clinically and economically.

Otorhinolaryngology and Diving-Part 2: Otorhinolaryngological Fitness for Compressed Gas Scuba Diving: A Review.

Importance: Self-contained underwater breathing apparatus (scuba) diving has become increasingly popular with millions of people diving each year. Otorhinolaryngologists are often consulted either by patients or diving physicians regarding fitness to dive, and at present, the guidelines do not provide comprehensive information regarding the evaluation of this patient cohort. The aim of this review is to provide a comprehensive overview of existing otorhinolaryngological guidelines for fitness to dive recreationally.

Otorhinolaryngology and Diving-Part 1: Otorhinolaryngological Hazards Related to Compressed Gas Scuba Diving: A Review.

Importance: Scuba diving is becoming increasingly popular. However, scuba diving is associated with specific risks; 80% of adults and 85% of juvenile divers (aged 6-17 years) have been reputed to have an ear, nose, or throat complaint related to diving at some point during their diving career. Divers frequently seek advice from primary care physicians, diving physicians, and otorhinolaryngologists, not only in the acute setting, but also related to the long-term effects of diving.

Acute dystonic reaction to general anesthesia with propofol and ondansetron: a graded response.

Propofol and ondansetron, alone and in combination, have been associated with acute dystonic reactions during recovery from anesthesia. We report the case of a 44-year-old woman who had undergone microlaryngoscopic fat injection to the vocal folds three times over a period of 10 months. Each procedure was performed by the same surgeon.

An investigation of abdominal muscle recruitment for sustained phonation in 25 healthy singers.

Objectives: The purpose of this study was to investigate the baseline muscle thickness and recruitment patterns of the transversus abdominis muscle (TAM) and the internal oblique muscle (IOM) during semisupine phonation in a group of healthy performers.

Study Design: This was a 2 × 3×2 within-group, repeated-measure study in which 25 professional vocalists--12 male and 13 female performed a series of sustained pitches in differing vocal qualities. Measurements were taken with ultrasound (Sonosite Micromaxx Ultrasound System) of the baseline thickness and % recruitment during voicing, of two deep abdominal muscles--TAM and the IOM.

A comparison of the voice handicap index-10 scores between medical and musical theater students.

Objective: Elite professional voice users experience a high vocal load and if voice quality deteriorates, their livelihoods are affected. Our aim was to assess how an elite professional voice user group, musical theater students (n=49), perceive their voices in comparison with medical students (n=43).

Study Design: Cross-sectional study.

Allergic laryngitis as a cause of dysphonia: a preliminary report.

Objectives: To investigate the relationship between air-borne allergen exposure and Voice Handicap Index scores in patients seeking medical treatment for rhinitis.

Methods: As we had previously identified a higher-than-expected incidence of allergy in patients presenting to a voice clinic, we undertook a prospective audit of patients without specific voice-related complaints presenting to a rhinology clinic to see if these patients might have unrecognized vocal dysfunction. To this end 70 consecutive patients with no pre-reported voice-related symptoms presenting to a teaching hospital rhinology clinic underwent skin prick testing to common air-borne allergens and completed the Voice Handicap Index (VHI) questionnaire.

A single-centre retrospective review of unilateral and bilateral Dysport injections in adductor spasmodic dysphonia.

We reviewed the results and side-effect profile of the Dysport preparation of botulinum toxin A (BTA) in the management of the adductor spasmodic dysphonia. We performed 272 injection episodes in 68 patients, 42 (62%) female, 26 (38%) male. A total of 116 of these injections were unilateral, and 156 were bilateral; 94% of the injections were considered to have been successful with a voice score of 2 or higher.

Is dysphonia due to allergic laryngitis being misdiagnosed as laryngopharyngeal reflux?

Objectives: Voice problems affect up to 30% of the population at some time during their life, and in particular it affects those who use their voice professionally. Patients who commonly present with dysphonia are often found to have symptoms of both allergy and reflux. Clinical examination of the larynx often makes it difficult to differentiate between the main causative factors of dysphonia, as the clinical findings on nasendoscopy between reflux and allergy are similar.

The difficult airway: the use of subglottic jet ventilation for laryngeal surgery.

High-frequency subglottic jet ventilation was used in 352 cases of adults treated with suspension microlaryngoscopy. Of these, 89 had difficult airways, and these are the subject of this manuscript. All cases were managed by the senior anaesthesiologist (AP) and the senior surgeon (JR), between 2000 and 2004.

Musculoskeletal patterns in patients with voice disorders.

This study correlated the ear, nose, and throat (ENT) and physiotherapy input on 26 patients who presented with voice problems and were found by the ENT surgeon to have a degree of musculoskeletal issues. It also looked for patterns of musculoskeletal findings. Although all patients referred were found by the physiotherapist to have musculoskeletal abnormalities, the correlation proved to be excellent among the subgroup of performers, but only fair-to-good among the other voice professionals.

Subglottic jet ventilation for suspension microlaryngoscopy.

High-frequency subglottic jet ventilation was used in 142 consecutive adults with grade I airways treated with suspension microlaryngoscopy. All cases were managed by the senior anesthesiologist (AP) and the large majority by the senior surgeon (JR), between 2000 and 2002. The laser was used in 30% of cases.

The potential role of ultrasound in differentiating solid and cystic swellings of the true vocal fold.

Unlabelled: This study was designed to investigate the potential role of ultrasound in the diagnosis of cysts of the true vocal fold.

Materials And Methods: Grayscale ultrasound of the larynx was carried out in 29 patients with a swelling of the true vocal fold and dysphonia. The findings were then compared with those at subsequent microlaryngoscopy, in the majority of cases.

Psychogenic voice disorders in performers: a psychodynamic model.

Psychogenic voice disorders are not infrequently encountered in the busy voice clinic. A clinician-friendly psychodynamic model and a multidisciplinary management approach are presented which have proven helpful for our voice team and our patients. In essence the formulation revolves around an "event" occurring, which may be either organic or psychological in nature.