Precision-Targeted Injection Laryngoplasty and Longitudinal Biomaterial Effects Evaluation Using High-resolution Ultrasonography in a Rat Model.

Objective: Current laryngeal injection models rely on the transoral route and are suboptimal due to limited view, narrowed working space, and the need to sacrifice animals for investigation of the injectables. In the present study, a novel surgical model for laryngeal intervention therapy utilizing an ultra-high frequency ultrasound imaging system was proposed. Based on this system, we developed a systemic evaluation approach, from guidance of the injection process, documentation of the injection site of the material, to in vivo longitudinal follow-up on the augmentation and medialization effect by analyzing the ultrasonography data.

Identification and analysis of Nonlinear behaviors of vocal fold biomechanics during phonation to assess efficacy of surgery for benign laryngeal Diseases.

Background: Current voice assessments focus on perceptive evaluation and acoustic analysis. The interaction of vocal tract pressure (P) and vocal fold (VF) vibrations are important for volume and pitch control. However, there are currently little non-invasive ways to measure P.

Effects of a swallowing and oral-care program on resuming oral feeding and reducing pneumonia in patients following endotracheal extubation: a randomized, open-label, controlled trial.

Background: The resumption of oral feeding and free from pneumonia are important therapeutic goals for critically ill patients who have been successfully extubated after prolonged (≥ 48 h) endotracheal intubation. We aimed to examine whether a swallowing and oral-care (SOC) program provided to critically ill patients extubated from prolonged mechanical ventilation improves their oral-feeding resumption and reduces 30-day pneumonia incidence.

Methods: In this randomized, open-label, controlled trial, participants were consecutively enrolled and randomized to receive the SOC program or usual care.

Proton Pump Inhibitor-unresponsive Laryngeal Symptoms Are Associated With Psychological Comorbidities and Sleep Disturbance: A Manometry and Impedance-pH Monitoring Study.

Background/aims: Laryngeal symptoms are largely treated with empiric proton pump inhibitor (PPI) therapy if no apparent pathology shown on ear, nose, and throat evaluation and reflux-related etiologies are suspected. However, treatment response remains unsatisfactory. This study aimed to investigate the clinical and physiological characteristics of patients with PPI-refractory laryngeal symptoms.

Effects of surgery on the relationship between subglottic pressure and fundamental frequency in vocal fold dynamics in patients with benign laryngeal diseases.

Purpose: Subglottic pressure (P) and fundamental frequency (F) play important roles in governing vocal fold (VF) dynamics. Theoretical description, model simulation, excised larynx and animal models have been used in previous studies, yet clinically applicable measurements are still lacking. This study aimed to evaluate the effects of surgery for benign laryngeal lesions by investigating the relationship between F and P.

Predicting feeding-tube dependence in patients following endotracheal extubation: a two-item swallowing screen.

Background: To meet the surging demands for intubation and invasive ventilation as more COVID-19 patients begin their recovery, clinicians are challenged to find an ultra-brief and minimally invasive screen for postextubation dysphagia predicting feeding-tube dependence persisting for 72 h after extubation.

Methods: This study examined the predictive validity of a two-item swallowing screen on feeding-tube dependence over 72 h in patients following endotracheal extubation. Intensive-care-unit (ICU) patients (≥ 20 years) successfully extubated after ≥ 48 h endotracheal intubation were screened by trained nurses using the swallowing screen (comprising oral stereognosis and cough-reflex tests) 24 h postextubation.

Long-term swallowing-related outcomes in oral cancer patients receiving proactive swallowing therapy.

Objectives: The present study aimed to evaluate the impact of proactive swallowing rehabilitation on swallowing function and quality of life (QoL) in oral cancer patients in the first two years after definitive treatment.

Materials And Methods: Consecutive adult patients with locally advanced oral cancer who received radical surgery, free flap reconstruction, and adjuvant radiotherapy were recruited prospectively, to whom proactive swallowing rehabilitation was provided. Body weight (BW); fiberoptic endoscopic evaluation of swallowing (FEES), functional oral intake scale (FOIS), and diet level; 10-item eating assessment tool (EAT-10), and MD Anderson Dysphagia Inventory (MDADI); and adherence at baseline, 1, 3, 6, 12, and 24 months were evaluated.

Anatomical and physiological characteristics in patients with Laryngopharyngeal Reflux Symptoms: A case-control study utilizing high-resolution impedance manometry.

Background/purpose: This study aimed to explore the anatomical and physiological characteristics of patients with laryngopharyngeal reflux (LPR) symptoms, such as hoarseness, throat clearing, throat pain, globus, and chronic cough, with the novel high-resolution impedance manometry (HRIM).

Methods: Consecutive patients exhibited at least one LPR symptom for ≥4 weeks after 2-month proton-pump inhibitor treatment were enrolled during November 2014 and March 2018 from single tertiary medical center. All patients completed validated symptom questionnaires, esophagogastroduodenoscopy, and HRIM.

Objective evaluation of biomaterial effects after injection laryngoplasty - Introduction of artificial intelligence-based ultrasonic image analysis.

Objective: Hyaluronic acid (HA) can be degraded over time. However, persistence of the effects after injection laryngoplasty (IL) for unilateral vocal fold paralysis (UVFP), longer than expected from HA longevity, has been observed. The purpose of the study was to develop a methodology with clinical utility for objective evaluation of the temporal change in HA volume after IL using artificial intelligence (AI)-based ultrasonic assessment.

Effects of a swallowing and oral care intervention for patients following endotracheal extubation: a pre- and post-intervention study.

Background: For patients who survive a critical illness and have their oral endotracheal tube removed, dysphagia is highly prevalent, and without intervention, it may persist far beyond hospital discharge. This pre- and post-intervention study with historical controls tested the effects of a swallowing and oral care (SOC) intervention on patients' time to resume oral intake and salivary flow following endotracheal extubation.

Methods: The sample comprised intensive care unit patients (≥ 50 years) successfully extubated after ≥ 48 h endotracheal intubation.

Estimating vocal fold stiffness: Using the relationship between subglottic pressure and fundamental frequency of phonation as an analog.

Objective: The stiffness of the vocal folds is an important factor in voice production, yet clinically applicable measurements are still lacking. It has been demonstrated in an in vivo canine model that fundamental frequency (F ) increased linearly as subglottic pressure (P ) increased, but with a lesser slope for higher levels of vocal fold tension. In this study, the relationship between F and P was investigated using the airflow interruption method in awake patients non-invasively.

Nonintubated laryngomicrosurgery with Transnasal Humidified Rapid-Insufflation Ventilatory Exchange: A case series.

Background: Nonintubation anaesthesia for laryngomicrosurgery (LMS) provides both excellent visualization of the surgical field and complete examination on vocal cord. However, adequate oxygenation remains challenging during nonintubated LMS. Recently, transnasal humidified rapid-insufflation ventilator exchange (THRIVE) has been reported effectively maintaining apneic oxygenation in patient with difficult airways.

Ultrasonographic Evaluation of Upper Airway Structures in Children With Obstructive Sleep Apnea.

Importance: Adenotonsillar hypertrophy is an important cause of obstructive sleep apnea (OSA) in children. However, residual OSA and abnormal polysomnographic findings have been reported in up to 75% of cases after adenotonsillectomy. Other anatomical and functional factors that influence upper airway structures, including the lateral pharyngeal wall, have rarely been studied in children with OSA.

Double-blind, placebo-controlled study with alginate suspension for laryngopharyngeal reflux disease.

Objective: Treatment for laryngopharyngeal reflux disease (LPRD) is challenging because of delays in recognition and poor responsiveness to proton-pump inhibitor therapy. The aim of this study was to determine the efficacy and safety of liquid alginate suspension for treating LPRD.

Methods: A double-blind, placebo-controlled, prospective study comparing 8 weeks of treatment with Alginos Oral Suspension (TTY Biopharm Co.

Bedside screen for oral cavity structure, salivary flow, and vocal production over the 14days following endotracheal extubation.

Purpose: To describe the sequelae of oral endotracheal intubation by evaluating prevalence rates of structural injury, hyposalivation, and impaired vocal production over 14days following extubation.

Materials And Methods: Consecutive adults (≥20years, N=114) with prolonged (≥48h) endotracheal intubation were enrolled from medical intensive care units at a university hospital. Participants were assessed by trained nurses at 2, 7, and 14days after extubation, using a standardized bedside screening protocol.

Pediatric tracheotomy: A comparison of outcomes and lengths of hospitalization between different indications.

Objectives: To assess outcomes of pediatric tracheotomy and duration of associated hospital stay according to indications.

Subjects And Methods: In this retrospective study, subjects were 142 consecutive pediatric patients (<18 years old) who underwent tracheotomy at a tertiary referral medical center, National Taiwan University Hospital, in 1997-2012. Age, sex, indications, pre-operative status (oxygen demand, number of repeated intubations), and post-operative status (duration of weaning, length of hospital stay, mortality) were analyzed.

Impacts of disease severity on postoperative complications in children with sleep-disordered breathing.

Objectives/hypothesis: To investigate the effects of diseases severity on postoperative complications following adenotonsillectomy (T&A) in children with sleep-disordered breathing (SDB).

Study Design: Retrospective study.

Methods: Children aged <18 years were enrolled and underwent T&A for treating SDB.

Swallowing dysfunction following endotracheal intubation: Age matters.

To evaluate postextubation swallowing dysfunction (PSD) 21 days after endotracheal extubation and to examine whether PSD is time-limited and whether age matters.For this prospective cohort study, we evaluated 151 adult critical care patients (≥20 years) who were intubated for at least 48 hours and had no pre-existing neuromuscular disease or swallowing dysfunction. Participants were assessed for time (days) to pass bedside swallow evaluations (swallow 50 mL of water without difficulty) and to resume total oral intake.

Clinical risk assessment model for pediatric obstructive sleep apnea.

Objectives/hypothesis: To develop a clinical risk prediction model that identifies children with obstructive sleep apnea (OSA) in a clinical setting by examining the symptoms, physical status, and OSA-18 questionnaire results.

Design: Single institutional, cross-sectional study.

Methods: Children aged 2 to 18 years with symptoms of OSA were enrolled.

Application of Ultrasound-Guided Core Biopsy to Minimal-Invasively Diagnose Supraclavicular Fossa Tumors and Minimize the Requirement of Invasive Diagnostic Surgery.

Tumors of the supraclavicular fossa (SC) is clinically challenging because of anatomical complexity and tumor pathological diversity. Because of varied diseases entities and treatment choices of SC tumors, making the accurate decision among numerous differential diagnoses is imperative. Sampling by open biopsy (OB) remains the standard procedure for pathological confirmation.

Application of ultrasound-guided core biopsy to minimize the non-diagnostic results and the requirement of diagnostic surgery in extrapulmonary tuberculosis of the head and neck.

Purpose: Head and neck extrapulmonary tuberculosis (ETB) presenting as lymphadenopathy poses a great threat by potentially increasing the deterioration of clinical outcomes. Tissue sampling for diagnostic confirmation of ETB is the only invasive procedure during the entire clinical course. It is, therefore, necessary to establish ETB sampling methods with accuracy and minimal invasiveness.

Evaluation of swallowing disorders by use of transnasal esophagoscopy in patients treated for head and neck cancer.

Background: The purposes of this study were to identify an index of symptoms and signs of swallowing disorders that indicate the occurrence of local recurrence or second primary malignancy and to evaluate the application of transnasal esophagoscopy in patients treated for head and neck squamous cell carcinoma (HNSCC).

Methods: Patients treated for HNSCC with swallowing disorders who received transnasal esophagoscopy examinations between January 2010 and June 2014 were included in this study. Local recurrence and second primary malignancy were pathologically diagnosed.

Comparison of rigid and flexible endoscopy for removing esophageal foreign bodies in an emergency.

Background/purpose: Despite the effectiveness of endoscopies in removing ingested foreign bodies (FBs) impacted in the esophagus, the merits and limitations of flexible endoscopy (FE) and rigid endoscopy (RE) remain unclear. Therefore, this study compares the advantages and disadvantages of both endoscopic procedures from a clinical perspective.

Methods: A retrospective review was made of 273 patients suspected of esophageal FBs in emergency consultations of a tertiary medical referral center from March 2010 to March 2014.

Comprehensive Outcome Researches of Intralesional Steroid Injection on Benign Vocal Fold Lesions.

Objective: This study investigated multidimensional treatment outcomes, including prognostic factors and side effects of vocal fold steroid injection (VFSI).

Methods: We recruited 126 consecutive patients, including patients with 49 nodules, 47 polyps, and 30 mucus retention cysts. All the patients received VFSI under local anesthesia in the office settings.