David W. Brewer

Functional staging for vocal cord paralysis.

Phonatory function can be reliably tested after vocal paralysis. After a review of 116 cases, 55 patients underwent objective testing. The clinical history of vocal ability and aspiration were found to be significantly correlated with measurements of phonatory mean flow rate (MFR), maximum phonation time (MPT), and maximum decibel output (SPL). A four-stage classification system, based on clinical and objective measurements, has been formulated. In stage I, measures of vocal parameters approached those of normals with MFR = 155 cc/sec, MPT = 12 sec, and SPL = 92 dB. Patients with stage IV disability have high MFR (480 cc/sec), but low MPTs (<3 sec) and low SPL values (76 dB). Factors such as sex, age, weight loss, and the presence of malignancy affect the degree of vocal function deficit. Post-therapy recordings indicated an improvement in vocal function by an increase in MPT and SPL, with a decrease in MFR. Measurements of MFR, PT, and SPL are good objective indicators available to the clinician. Functional staging can be applied to assessment and treatment of vocal cord paralysis.

International Association of Logopedics and Phoniatrics (IALP) Voice Committee Discussion of Assessment Topics

D i s c u s s a n t s : D i a n e M. B le s s , R o n a l d J. B a k e n , T h o m a s H a c k i , B j o r n Fr i t ze l l , J o h n L a v e r , H a r m S c h u t t e , M i n o r u H i r a n o , E r n s t L o e b e l l , I n g o T i t ze , M a r i e A g n e s F a u r e , A n d r e Mul le r , J t i rgen W e n d l e r , S r r e n F e x , M. N a s s e r K o t b y , D a v i d B r e w e r , A a t t o S o n n i n e n , a n d Pe r t t i H u r m e

Pitfalls and problems in flexible fiberoptic videolaryngoscopy

Summary The flexible fiberoptic laryngoscope is a valuable tool in the examination of laryngeal and supraglottic structure and function. Nevertheless, persistent questions remain about the validity of the perceived image, and a variety of concerns arise relative to the equipment used, the difficult to examine patient, and the difficulty in obtaining measurable objective data. All of these areas are discussed. Distortions of the video image that result from the wideangle lens effect are described. Given an awareness of the distortions that may be present in the fiberoptic video image, it is clear that it is necessary to exercise caution in making judgments of anatomic or physiologic integrity based on fiberoptic information alone.

Digital processing of laryngeal images: A preliminary report

Summary A low-cost microcomputer (Amiga 1000) and software were used to digitize and analyze slides, high-speed films, and video tapes of laryngeal images. The images were digitized with a 320 horizontal by 200 vertical pixel resolution and at 16 gray levels. Various algorithms were used to analyze the images, including color equalization, color merging, edge detection, and histogram analysis. An example is presented where the area of a nodule and the area of the glottis are measured using some of the processing techniques and compared to similar measurements obtained by hand. The quality of the digitized images obtained with this low-cost system is very good. Simple image-processing techniques, commercially available, are well suited to the analysis of laryngeal images and should permit sophisticated processing of movement of structures within the larynx.

G. Paul Moore Lecture Voice research: The next ten years*

Summary A partial list of voice problems has already been identified in previous publications, conferences, and symposia. Many remain unsolved and form our research challenge. A specially designed matrix can be used as a research catalyst. When constructed from appropriate lists of academic disciplines and research tools, each matrix should stimulate us to propose solutions to our unsolved problems.

Panel The integration of voice science, voice pathology, medicine, public speaking, acting, and singing

The integration of voice science, voice pathology, medicine, public speaking, acting, and singing has been central to evolution in all fields. The Voice Foundation Symposia have played a seminal and central role in fostering integration among disciplines. The result has been an improvement in the knowledge and practice in each field. And the future promises to be even more informative and exciting.

Effect of inositol feeding on inositol phosphatides and other lipids of human blood plasma.

Summary A group of 13 patients with high tone deafness was treated with 3 g oral inositol daily for periods of 1 to 12 months. No change resulted in the fasting plasma inositol phosphatide concentration; there were minor increases in total and free cholesterol and total phospholipids, and there was an apparent decrease in neutral fat.