Læknablaðið : fylgirit - 01.06.2005, Blaðsíða 30

ABSTRACTS / XXIX CONGRESS OF THE NORDIC ASSOCIATION OF OTOLARYNGOLOGY
With the high speed camera system developed in Erlangen,
Germany, we have found that visual judgements of vibration and
mucosal waves are fast and easy to perform. It is also possible to
make kymograms and motion analysis in the clinical setting.
Abstract no.: 068
Transcutaneous autologous fat injection for unilateral vocal
fold paralysis
Alkestrand B, ENT department, Hospital of Helsingborg
Unilateral vocal fold paralysis is not an uncommon condition. For
many years it has been a therapeutic challenge.
There are three main therapeutic goals:
1. A less breathy voice.
2. An adequate expectoration.
3. Less aspiration to the bronchial tree.
Autologous fat is a near-ideal substance for vocal fold
augmentation. It is readily available and easily harvested from
the abdomen. It is a natural substance with the similar consistency
to surrounding tissue and with no foreign-body reaction. Further
more it is easy to inject and will give rise to a smooth free margin
of the vocal cord. Mainly it is injected deep into the thyroarytenoid
muscle of the paralyzed vocal cord, but can also be deposited
more superficially in order to correct rninor deformity.
The transcutaneus injection technique has several advantages:
the procedure can be in an outpatient setting under local anaes-
thesia, simultaneous videolaryngostroboscopy while the patient is
phonating enables the assessment of adequate injection volume.
The technique will be described in detail, including photo- and
videodocumentation. Pros and contras concerning autologous fat
/ the transcutaneous technique - and results - will be discussed.
Abstract no.: 069
Laryngeal reinnervation after bilateral paralysis
Spren Fex
Established neuro-physiological facts to consider at re-innerva-
tion: It is the nerve which decides the muscle function, never the
reverse. An innervated muscle fiber does not accept innervation
by another nerve. After a damage to a nerve resulting in degen-
eration an ensuing regeneration will be random.
As at vocal fold immobility respiratory difficulties are the most
important, after securing denervation, posticus muscle activity has
been effected by implanting the phrenic nerve in the muscle, thus
causing abduction at inspiration. This was first made on cats but
nowadays also on humans with satisfactory results.
Abstract no.: 070
Vocal fold nodules; surgical vs non-surgical interventions
Mette Pedersen, MD, FRCS, Dr. Med. Sci. ear-, nose- and throat specialist,
consultant phoniatrician, The Medical Centre, 0stergade 18, Copehagen,
Denmark m.f.pcdcrsen@dadlnet.dk
Introduction: There is no evidence of any kind of treatment that
has an effect on vocal nodules. The problem is that untill now
no high quality prospective randomised blinded studies have
been carried out, as shown in a Cochrane review by Pedersen
and McGlashan in 2000(1). No evidence based results of speech
therapy and/or surgery was found.
Methods and results: Two prospective pilot studies of vocal
nodules were made based on the Cochrane review. In one study
Voice-Related-Quality-Of-Life (VRQOL) was shown to be better
after voice related treatment of infections, allergy and reflux, a
small improvement was also seen after high quality medical voice
hygiene advice. In the other (case-control) study, voice related
medical treatment in Zagreb was compared with medical treat-
ment in Copenhagen to show eventual geographical differences
of the medical approach of treatment of related infections, allergy
and reflux. GRBAS perception test and the Multi-Dimensional-
Voice-Program as well as VRQOL were better after treatment in
both places compared to controls.
Conclusion: It is necessary to re-evaluate the whole area of treat-
ment of benign voice disorders because new measurement - and
medical treatment - possibilities have been developed.
Refcrence
1. Pedersen M, McGlashan J. Surgical versus non-surgical interventions for vocal
cord nodules, the Cochrane library, Oxford 2000.
Abstract no.: 071
Voice therapy and surgery for the MtoF transsexual
Jamie Koufman, MD, FACS, Director, Center for Voice and Swallowing
Disorders of Wake Forest University and Professor of Surgery
(Otolaryngology), Wake Forest University Health Sciences, Medical
Center Boulevard, Winston-Salem, NC 27157-1034, Tel (336) 716-3876 or
716-8877, jkoufman@wfubmc.cdu www.lhevoicccenter.com
This presentation reviews female voice and speech characteristics
and provides the participant with an approach to voice therapy.
In addition, voice feminization surgical procedures are presented
and discussed. The workshop outline:
• Voice is a very difficult issue for many transsexual women
• Common laryngeal and voice problems that affect trans-
sexuals
• Significant differences between the natal male and female
voices
• Anatomy and physiology of the larynx and voice: How the
voice works
• Voice feminization surgical procedures: Surgery, yea or nay?
• Voice therapy: The elements of effective voice feminization
• Perils of the tracheal shave procedure
• New therapeutic options already on the horizon
S-XII THE FUTURE OF NORDIC OTORHINOLARYNGOLOGY
Abstract no.: 072
European Academy of Otorhinolaryngology - Head and
Neck Surgery
Grénman R, Department of Otorhinolaryngology - Head and Neck
Surgery, Turku University Central Hospital, Turku, Finland
The European National Societies of Otorhinolaryngology - head
30 Læknablaðið/Fylgirit 51 2005/91