Unilateral laryngeal paralysis is often caused by diseases of the cervicothoracic region. Approximately 50% of cases occur after intubation and other surgical procedures, and the number of cases is likely to increase in the future. Conservative therapy and phonosurgery play a significant role in the treatment of dysphonia accompanying unilateral laryngeal paralysis. In the present study, factors affecting the level of postoperative vocal improvement in injection laryngoplasty were investigated, and the transition time from voice therapy to surgical procedure was examined.
The present study findings showed that the maximum phonation time prior to injection thyroplasty was often shorter in relatively older patients, i.e. patients aged ≥60 years, compared to those aged <60 years, and that this shortening had an effect on postoperative vocal improvement. Age also had an impact in patients who required surgical procedure due to insufficient vocal improvement with voice therapy alone.
Based on our findings, we consider that injection laryngoplasty is a viable initial therapy that should be performed early on and without a waiting period in relatively older patients with diminished QOL because it does not involve incision of the skin and has few complications.
Wolf and Bowers (1999) proposed the double-deficit hypothesis of developmental dyslexia in which, in addition to phonological deficit, they put forward naming speed deficit as a second core factor of developmental dyslexia. They also reported the double deficit group showing both phonological and naming speed deficits manifested in the most severe reading difficulty. In this study, we investigated the adaptation of the double-deficit hypothesis to 94 Japanese third grade children attending public school. For the sake of comparisons with foreign studies, we used the same criteria as Sunseth and Bowers (2002) for English speakers and the same as Wimmer et al (2000) for German-speaking third graders. The results indicated that, for both sets of criteria, Japanese-speaking children can be classified into three subgroups based on the double-deficit hypothesis. However, the double deficit group was not the most severe group in all tasks. Our findings suggest that the double-deficit hypothesis applies only partly in the case of Japanese third grade children.
The phonological deficit hypothesis is the most convincing hypothesis for developmental dyslexia in English-speaking countries. In addition, the phonological deficit hypothesis has been reported to be related to specific language impairment (SLI). It is thought that phonological short-term memory affects vocabulary, which has also been reported to be the cause of SLI. However, it is not clear how phonological deficit affects language disorder in developmental dyslexia and SLI. Therefore, in this study we investigated 519 primary school children, and carried out cognitive and attainment tasks in relation to reading/writing and language development. The purpose of this study is to clarify the effects of the phonological deficit on developmental dyslexia and SLI.
The results indicated that the poor reading/writing group showed weak phonological awareness, and the poor vocabulary group showed weak phonological short-term memory. However, 22 children out of 38 from the poor reading/writing group and 9 children out of 16 from the poor vocabulary group did not show a phonological deficit. Therefore, we speculated that they were variant groups.
A case of pediatric acquired dyslexia/dysgraphia (PAD) without aphasia is reported here. A one-year-old, right-handed boy with Moyamoya disease was subjected to neuropsychological (NP) and cognitive neuropsychological (CNP) tests concerning dyslexia/dysgraphia, and his case was compared to cases of PAD with aphasia and to cases of developmental dyslexia. In the comparison with cases of PAD with aphasia, the present case characteristically combined with visual-memory impairment. In the comparison with cases of developmental dyslexia, his impaired Kana reading and writing was preferentially impaired, although cases with developmental dyslexia would usually show impaired Kanji reading/writing. Kana-preferential reading/writing disturbance has neither been reported in cases of adult onset PAD without aphasia. The problem in visual memory and phonological ability observed in the current case may be the cause of these differences.
We report a case of functional dysphonia which we initially suspected of psychogenic dysphonia. Some reasons why we suspected psychogenic dysphonia were that fiberoptic observation of the vocal folds showed conversion aphonia, the patient had suffered aphonia in the past, and she was taking paroxetine hydrochloride hydrate for dizziness. We then tried voice therapy, and she was generally satisfied with her voice. She continued the voice therapy, and after six sessions of therapy her complaint disappeared without psychogenic symptoms. We concluded that priority of treatment for psychogenesis was low in this case. Our findings suggest that when psychogenic dysphonia is suspected, voice therapy may be tried when the response of the patient at the initial session is favorable.
Elite vocal performers (EVPs) are professional performers who use their voice to give artistic expression: for example, professional singers and theater actors. The therapies that EVPs require to improve their voice quality are extremely delicate. In the present study, we conducted a questionnaire survey of EVPs to understand their awareness of treatments provided by otolaryngologists and voice doctors and their own therapy requirements to treat their voice problems.
We prepared a questionnaire consisting of 28 multi-choice questions and 3 open-ended questions and conducted an anonymous survey using it. We obtained responses from 92 EVPs (41 men and 51 women). The questionnaire included questions about "voice symptoms," "otolaryngological examination and vocal coaching," "silence cure," "steroid therapy," "solutions for voice problems," "therapy requirements," etc.
With 64% of the respondents, silence cure had been prescribed. We think it is important to give these patients instruction on the appropriate duration of the therapy. Some 68% of the respondents had received steroid therapy. About half of them desired medication only in emergency situations, and the other half avoided medication if at all possible.