Muriel Spark's 'informed air': the auditory imagination and the voices of fiction.

'Events occur in my mind', Spark has written, 'and I record them'. What does it mean to hear something that isn't there? Hearing inner speech or sounds, not as silent thoughts but as quasi-perceptual events in the world, confounds settled distinctions between perception, memory and imagination that structure our feeling of the real. This essay shows how her capacity for complex 'listening in' becomes the mainspring of her brilliance as an experimental writer, cultural observer and fictional ethicist.

The novel as therapy: Ministrations of voice in an age of risk.

Examining relations between 'therapy culture' and the 'risk society', this essay suggests that the novel developed to offer a powerful workout for the kinds of socio-cognitive capacities and gratifications required by the complex and 'emergent' cultures of modernity: recursive skills of mindreading and mental time-travelling, the negotiation of plural ontologies. Its development of a unique mode of 'double voicing' allowed readers to situate the interior life in a complex and dynamic relation to the social. Reading novels challenges the default, making 'safe', capacities of the probabilistic or Bayesian brain.

Disease-specific self-efficacy in spasmodic dysphonia patients.

Objective: Self-efficacy (SE) is an optimistic self-belief that one can perform a novel task. This concept involves empowerment, self-esteem, and adaptation to a stressful situation. SE is a strong predictor of health behaviors.

The role of experience on judgments of dysphonia.

Objectives: The objectives of the study were (1) to determine differences in judgments of overall severity (OS) and vocal effort (VE) of dysphonic speech when judgments were made by experienced and inexperienced listeners, and when self-rated by individuals with dysphonia; and (2) to determine relationships between auditory-perceptual judgments of voice and voice handicap.

Study Design: Prospective and exploratory.

Methods: Twenty speakers with dysphonia and four normal controls provided speech recordings.

Dosage changes in patients with long-term botulinum toxin use for laryngeal dystonia.

Objective: To investigate the dosage consistency of botulinum toxin injections in patients with long-term treatment for laryngeal dystonia.

Study Design: Chart review.

Subjects And Methods: Patients with laryngeal dystonia who had received at least 20 injections to the thyroarytenoid muscle were selected.

Effect of experience on judgments of adductor spasmodic dysphonia.

Objectives: We performed a prospective, exploratory study 1) to determine differences in judgments of overall severity (OS) and vocal effort (VE) in adductor spasmodic dysphonia (ADSD) when judgments are made by experienced listeners, naive listeners, and speakers with ADSD; 2) to determine differences in judgments of listener comfort (LC) in ADSD when judgments are made by experienced and naive listeners; and 3) to determine relationships between auditory-perceptual ratings of voice and speakers' voice handicap.

Methods: Twenty speakers with ADSD provided speech recordings. They judged their own speech samples for OS and VE and completed the Voice Handicap Index (VHI).

A new electromyographic definition of laryngeal synkinesis.

Laryngeal synkinesis involves the misdirected reinnervation of an injured recurrent laryngeal nerve to vocal fold abductor and adductor musculature. The resultant laryngeal dyscoordination can cause vocal fold immobility and airway compromise. Although this entity is sometimes considered in the differential diagnosis, it is only demonstrable with laryngeal electromyography (EMG).

Findings of multiple muscle involvement in a study of 214 patients with laryngeal dystonia using fine-wire electromyography.

Although perceptual and stroboscopic data help in diagnosing and classifying laryngeal dystonia, these measures do not aid the voice clinician in targeting which specific muscles to treat with botulinum toxin. Most patients achieve smoother, less effortful voicing with standard injection regimens. However, there is a notable failure rate.

Tremor laryngeal dystonia: treatment of the lateral cricoarytenoid muscle.

Tremor laryngeal dystonia is a clinical entity distinct from adductor laryngeal dystonia, according to perceptual, stroboscopic, and fine-wire electromyographic findings. Treatment with botulinum toxin has proven more difficult for tremor laryngeal dystonia than for adductor laryngeal dystonia, yet no treatment variations have been considered that might produce improved clinical results. We present 81 patients with a clinical presentation of tremor laryngeal dystonia who were treated with a variety of approaches with botulinum toxin.

Treatment of the interarytenoid muscle with botulinum toxin for laryngeal dystonia.

The treatment of laryngeal dystonia with botulinum toxin has provided various degrees of relief to the majority of patients with adductor dysphonia; however, a significant number of patients have limited or no improvement with this type of therapy. It remains unclear why some patients respond to the routine administration of toxin to the thyroarytenoid muscles whereas others do not. Injections into the lateral cricoarytenoid muscles have provided an improved voice in some patients who were unresponsive to injections into the thyroarytenoid muscles.

Electromyographic findings in recurrent laryngeal nerve reinnervation.

Abductor, adductor, and combined reinnervation procedures have been explored with variable success rates. We describe the experience of a tertiary care center with adductor reinnervation procedures, including preoperative and postoperative videostroboscopy and electromyography (EMG) findings. A retrospective chart review was performed from 1997 to 2001 that included 9 patients.