1. The human maculae flavae are involved in the metabolism of extracellular matrices essential for the viscoelasticity of the human vocal fold mucosa, and they maintain the layered structure of the human vocal fold.
2. Human maculae flavae are considered to be an important structure in the growth, development and ageing of the human vocal fold mucosa.
3. Vocal fold stellate cells contained in the human adult maculae flavae were discovered in 2001. They are stellate in shape and possess vitamin A storing lipid droplets.
4. There is growing evidence to suggest that the cells including vocal fold stellate cells in the maculae flavae are tissue stem cells of the human vocal fold, and maculae flavae are a candidate for a stem cell niche.
5. Research into the cells and extracellular matrices in the human vocal fold contributes not only to the basic knowledge of the physiology, pathology and pathophysiology of the vocal fold, but also to basic research in tissue engineering and regenerative medicine.
Otolaryngology, which deals mainly with organs for hearing and speech, is most closely related to medical studies on phonetic linguistics. Through the years our clinic has provided medical care primarily to communication-disabled children in cooperation with speech language hearing therapists (STs). Based on our experience we examined the current state of collaboration with STs in otolaryngology. In doing so we found a number of issues needing to be addressed.
A major benefit of participation by STs in ENT-related medical services is that the quality of treatment improves significantly. In addition, examination of infants by STs enables early detection of variously disabled children, and thereby makes it possible to initiate necessary care quickly.
At present, only very few clinics engage the services of STs. This situation results in a large number of children being brought to our clinic in order to be treated by a speech language hearing therapist—far beyond our capacity to treat all of them sufficiently. We hope that many otolaryngologists and STs will deepen their understanding of children's communication disorders, and actively participate in this field.
This study investigated the use of prosodic information by hearing-impaired children from the aspects of both utterances and hearing. The subjects were 31 children attending schools for the deaf and special classes for the hard of hearing (average hearing level: 86.2 dBHL (SD=23.4)). They were requested to utter syntactically ambiguous sentences which have two possible interpretations. Their utterances were evaluated for their auditory impression (prosodic use of articulation) by hearing people. The criteria considered were the correlation between hearing level and sound components by sound analysis (e.g. F0 or pause). The results indicated that the hearing level of the low frequency band (250 Hz, 500 Hz) is related to utilization of speech prosodic information. The average hearing level of 90 dBHL is the border value. These findings indicated that differentiation of syntactically ambiguous sentences is related to F0 and a pause. Hearing-impaired children use available sound components to express a syntactic boundary with F0 and a pause.
In the present study, we examined the relationship between prevalence of hoarseness and sports activities in 1,384 children who received health checks at their elementary or junior high schools. The prevalence of hoarseness was higher in boys (17.7%) than in girls (5.2%). At the elementary school level, boys had higher risk of hoarseness than girls. The prevalence of hoarseness in boys was high until the third grade and then turned to a decreasing trend. In girls, the prevalence of hoarseness was high until the second grade, here again followed by a decreasing trend, but at the junior high school level their rate turned high again in second and third year students. With senior elementary school boys, the prevalence of hoarseness was 21.2% with sports activities and 4.9% without sports activities, and was significantly higher than the corresponding 5.8% with sports and 0.6% without sports in senior elementary school girls. In junior elementary school boys, baseball was accompanied by a significantly high risk of hoarseness (odds ratio: 2.88), while in senior elementary school boys, playing baseball (odds ratio: 2.92) or soccer (odds ratio: 2.29) brought significant high risk of hoarseness. These results suggest that outdoor team sports associated with strong glottal closure at kicking, batting or vocalizing, such as baseball and soccer, lead to the development of hoarseness in elementary school boys. We concluded that voice hygiene education is needed for boys who play baseball or soccer to prevent the development of hoarseness.
Objectives: In the course of the past 1 year and 7 months, 53 patients, all singers with vocal disorder whose cause was thought to be nasopharyngitis, were examined and treated at Tokyo Voice Clinic. In this presentation, the relation between nasopharyngitis and voice disorder was discussed by studying the clinical records of these 53 patients.
Materials and Methods: The study involved an analysis of 53 patients (13 males, 40 females, 19 to 86 years of age; mean age, 49 years). In all patients, otolaryngological, phoniatric and endoscopic examinations, and evaluations by the Voice Handicap Index-10 (VHI-10) and the Singing Voice Handicap Index-10 (SVHI-10) were completed. Treatment was carried out by direct application of 1% zinc chloride solution. The clinical records of the patients were statistically studied for comparison between pre- and post-therapeutic data.
Results: Endoscopic findings, VHI-10, SVHI-10, and maximum phonation time (MPT) improved significantly. In 41 of the 53 patients SVHI-10 showed a decrease ≥5 points. The improvement rate was 78%.
Discussion and Conclusions: Nasopharyngitis is one of the diseases that cause voice disorder in singers with no organic lesion of the vocal folds. Treatment by direct application of 1% zinc chloride solution was effective. The pathology of nasopharyngitis was thought to be insufficiency of lubrication of the larynx due to dysfunction of the autonomic nerve system and resonant disorder of the nasopharynx.
The present study investigated whether sentence/phrase-end pitch-raising among young female speakers affects listeners' perception of professionalism. Sentence/phrase-end F0 in speech samples of ten young female speakers was digitally altered to make two types of stimuli: one with rising pitch and the other with falling pitch. Listeners rated the two types of stimuli for impression of professionalism. Data were first submitted to factor analysis, and three-way ANOVA with stimulus type, age group and gender of listeners as factors was performed on the factor scores of "professionalism." The results indicated that stimuli with falling pitch at the end of sentences/phrases were perceived as more professional and trustworthy.
A 40-year-old female patient with bamboo nodes caused by ankylosing spondylitis was treated by voice therapy and medical treatments with successful results. Endoscopic examination showed white band lesions in the middle of both vocal folds. The lesions of this case were thought to be vocal fold nodules attributable to vocal abuse. The condition of the vocal fold lesions and hoarseness changed in parallel with acute exacerbation or improvement of the ankylosing spondylitis. It was posited that both bamboo nodes and vocal fold nodules existed in this case.
This is the first report about bamboo nodes in ankylosing spondylitis. In clinical treatments, the vocal fold lesions of underlying autoimmune diseases should be considered for the possibility of bamboo nodes.
Problems associated with frequent pneumonia and excessive suction accompanying aspiration are the patient's own pain and the resulting burden on the family and care staff. Even if speech communication is not possible due to severe sensory aphasia, so long as the patient can utter vocalizations with emotion or quick voice, those important functions should be preserved. Therefore, surgical prevention for aspiration that will cause permanent vocal loss is not desirable even if it would enable recovery of oral intake. Here we report on the progress of our treatment of a patient with sensory aphasia accompanying severe dysphagia who recovered vocal communication and oral intake.
The case was a 48-year-old female. One year ago she underwent clipping of a left middle cerebral artery aneurysm. Two months later her cerebellar artery ruptured during cranioplasty. She underwent a decompressive craniectomy for the posterior fossa, but this was followed by severe dysphagia, and as those symptoms continued, she then underwent a tracheostomy and gastrostomy. She took home care after that but needed frequent suction all day long, so she was introduced to us for surgery to prevent aspiration. We elucidated the disease state of dysphasia in this case and undertook thorough treatment. Ultimately we were able to close the tracheal stoma and she recovered oral intake and vocal communication.