Vocal Rehabilitation using Stroboscpic Examination Silicone Injection in the Unilateral Paralyzed \ Vocal Cord \ Satoshi Kitahara, M.D. Department of
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1 Vocal Rehabilitation using Stroboscpic Examination Silicone Injection in the Unilateral Paralyzed \ Vocal Cord \ Satoshi Kitahara, M.D. Department of Otorhinolaryngology, School of Medicine, Keio University It is not until 1911 that Brunings found injection treatment of use for the correction of paralytic dysphonias. The advancement of the Brunings technique was not primarily with an improvement in technique itself but with the development of new injectable materials. It is well known that silicone is one of recommendable materials to be employed in the Brunings technique. Paracordal injection of silicone results in narrowing of the glottis. The voice can be considerably or even completely restored by this method thanks to reduced expiratory air consumption. As paracordal injection is thought one of functional therapeutic procedures, it is very reasonable to employ laryngostroboscopic procedure in this method in order to examine the vibratory pattern of the vocal cords. In this study, Brunings technique was laryngostroboscopically carried out for the first time. The author, hence, demonstrated that excellent restoration of the voice is due not only to narrowing of the glottis to reduce the air consumption, but also to obtaining nearly normal vibratory pattern of the vocal cords after injection of silicone. In this paper, the technique of silicone injection under laryngostroboscopy through the operation microscope was demonstrated and discussed from the viewpoint of analysis of stroboscopic vibratory patterns and phonetic examinations.
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14 ryng. Rhinol., 35; , ) von Leden, H.: The electronic synchron-stroboscone. Ann. Otol., 70; , ) von Leden, H., et al.: Laryngeal vibrations.: Measurements of the glottic wave. Part III The pathologic larynx. Arch. Otolaryng., 71; 16-35, ) von Leden, H., Moore, P.: Vibratory pattern of the vccal cords in unilateral laryngeal paral- ysis. Acta. Otolaryng., 53; , ) Hiroto, I.: Vibration of vocal cords on ultra high speed cinematographic study. (film), ) Pascher, W., et al.: Verbesserte visuelle Diagnostik in der Laryngologie und Phoniatrie. HNO, 19; , ) Seidner, W., et al.: Mikrostroboskopie. Folia 1) Brunings, W.: Uber eine neue Behandlungsme- phoniat., 24; 81-85, thode der Rekurrenslahumung. verhandl. Ver. Deutsch. Laryngol., 18; 93-98, ) Kleinsasser, O.: Mikrochirurgie im Kehlkopf. Arch. Ohrenheilk., 183; , dysphonia. IV Paralytic dysphonia due to unila- teral recurrent nerve paralysis. Arch. Otolaryng., 22) Arnold, G.E.: Vocal rehabilitation of paralytic 60; , ) Timke, R., et al.: Laryngeal vibrations.: Measurements 7) Ono, J., Saito, S.: Endoscopic microsurgery of of the glottic wave. Part I The normal vibratory cycle. Arch. Otolaryng., 68; 1-19, the larynx. Ann. Otol., 80; , ) Timke, R.: Die Synchron-Stroboskopie von menschlichen Stimmlippen bzw. ahnlichen Schal- 27) Arnold, G.E.: Vocal rehabilitation of paralyti c lquellen und Messung der Offnungszeit. Z. La- dysphonia. IX Technique of intracordal injection.
15 liquid silicone into ocular tissues. Am. T. Oph- Arch. Otolaryng., 76; , ) von Leden, H.: The mechanism of phonation. thalmol., 71; , ) Rees, T.D., et al.: Eyelid deformities caused A search fcr a rational theory of voice production. Arch. Otolaryng., 74; , by the injection of silicone fluid. Brit. J. Plast. Surg., 24; , ) Davis, P.K.B., et al.: The complication of 30) Rubin, H.J.: Pitfalls in treatment of dysphonias by intraccrdal injection of synthetics. Laryngoscope, 75; , ) Arnold, G.E.: Vccal rehabilitation of paralytic dysphonia. I Cartilage injection into a paralyzed vocal cord. Arch. Otolaryng., 62; 1-17, ) Arnold, G.E.: Vocal rehabilitation of paralytic dysphonia. VI Further studies of intracordal injection materials. Arch. Otolaryng., 73; , ) Cholnoky, T. de: Augmentation mammaplasty. Survey of complication in patients by 265 surgeons. Plast. Reconstr. Surg., 45; , ) Blodi, F.C.: Injection and impregnation of silastic implants. Experience with 137 consecutive cases. Brit. J. Plast. Surg., 24; , ) Lambert, J.A.: Microlaryngeal, surgery with neuroleptanalgesia and local anesthetic. Arch. Otolaryng., 94; , 1971.
Fig. 3 Flow diagram of image processing. Black rectangle in the photo indicates the processing area (128 x 32 pixels).
Fig. 1 The scheme of glottal area as a function of time Fig. 3 Flow diagram of image processing. Black rectangle in the photo indicates the processing area (128 x 32 pixels). Fig, 4 Parametric representation
STUDIES ON THE NERVE INNERVATION OF THE LARYNX Part II The Influence of Nerve Interception to the Vocal Cord Muscle By D.H. LEE, M.D. From the Departm
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1970. 8) Komorn, R. M. et al.: Vocal rehabilitation with a tracheo-esophageal shunt, Arch. Otolaryngol., 97: 303 `305, 1973. 10) Arslan, M. &Serafini, I.: Restoration of Laryngeal functions after total
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