OBJECTIVES This study aimed to assess the feasibility of gastroesophageal manometry for continuou... more OBJECTIVES This study aimed to assess the feasibility of gastroesophageal manometry for continuously evaluating the degree of expiratory effort by measuring the pressures in the digestive tract during crescendo phonation. METHODS Each of 18 healthy nondysphonic speakers had a probe with a four-channel gastroesophageal manometer inserted through the nasal cavity to place four pressure sensors in the hypopharynx, cervical-/thoracic esophagus, and stomach, and was asked to gradually increase the vocal loudness during sustained phonation of the vowel /e:/ (vowel-crescendo task), while the sound pressure level and the pressures were simultaneously recorded. RESULTS 50% of the successful vowel-crescendo task samples with a gradual and adequate sound pressure level increase showed a concomitant gradual increase in both the intra-thoracic-esophageal/intra-gastric pressure values from approximately -5 mmHg /6 mmHg to -10 mmHg/20 mmHg, respectively. The maximum pressure value was the highest in the intra-gastric pressure followed by the intra-thoracic-esophageal and intra-cervical-esophageal pressures in order. However, most of the samples showed less than one of atypical pressure changes, such as fluctuations in the intra-thoracic-esophageal and intra-gastric pressure changes and dispersion in the intra-cervical-esophageal and intra-hypopharyngeal pressure values (perhaps due to the peristaltic motions, and the contact of the sensors to the membranous wall). CONCLUSION These results show that, during successful crescendo phonation, gastroesophageal manometry reveals a gradual increase in the intra-thoracic and intra-abdominal pressures with increasing the vocal intensity, even though showing some systematic errors, suggesting the usefulness of gastroesophageal manometry for continuously evaluating the degree of expiratory effort without influence by the laryngeal condition.
【症例】77歳，女性。平成20年3月中旬から嗄声を自覚し，前医受診。喉頭腫瘍疑いにて4月上旬当科紹介受診。【治療前所見】右仮声帯の浮腫および右喉頭室の腫脹を認めた。CTでは甲状軟骨の内側に不自然... more 【症例】77歳，女性。平成20年3月中旬から嗄声を自覚し，前医受診。喉頭腫瘍疑いにて4月上旬当科紹介受診。【治療前所見】右仮声帯の浮腫および右喉頭室の腫脹を認めた。CTでは甲状軟骨の内側に不自然に空虚な領域を認めた。肺野条件下での冠状断CT所見では右傍声門間隙に気嚢胞を認め，内側型laryngoceleと診断した。【経過】再診時やや増大傾向を認めたため第7病日に入院し，第12病日に気管切開術およびラリンゴマイクロサージャリー下にて嚢胞開窓術を施行した。術中，嚢胞内部から少量の白色液とともに気泡の排出を確認した。【術後経過】術後1日目は右梨状窩から仮声帯にかけて比較的高度の浮腫を認めた。術後3日目にカニューレを抜去し，術後15日目で退院した。術後約2年のCTでは傍声門間隙に小結節影を認めるのみであり，現在のところ気嚢胞の再発を認めていない。【総括】ラリンゴマイクロサージャリー下での嚢胞開窓術は内側型laryngoceleに対して低侵襲かつ有効な術式である可能性を示唆する症例と考えられた。
Journal of voice : official journal of the Voice Foundation, Jan 10, 2016
The study aimed to investigate whether humming can immediately improve the regularity of vocal fo... more The study aimed to investigate whether humming can immediately improve the regularity of vocal fold vibration on electroglottography (EGG) and laryngeal high-speed digital imaging (HSDI) in patients with organic dysphonia (OD). In a series of 49 dysphonic patients who were diagnosed to have benign mass lesions in the vocal folds and an equal number of non-dysphonic speakers, perturbation parameters were calculated on the acoustic (Ac) and EGG signals during natural and humming phonation. In addition, 11 OD patients and as many non-dysphonic speakers underwent simultaneous EGG and HSDI video recording under laryngofiberscopy while performing the two tasks. The perturbation parameters of the EGG signals as well as the glottal area waveforms (GAW), which were extracted from the HSDI movies, were calculated, and the correlations between both perturbation parameters were analyzed. Humming achieved significant improvements in the EGG perturbation parameters in both groups. More than half ...
The present results indicate that the diagnosis of gastroesophageal reflux disease (GERD) is an i... more The present results indicate that the diagnosis of gastroesophageal reflux disease (GERD) is an independent etiological factor predicting retardation of the resolution of laryngeal granuloma. To assess the effects of combined usage of an inhaled corticosteroid plus tranilast and/or a proton pump inhibitor on the size of granulomatous lesions, and to reveal etiological factors related to the outcome using the Kaplan-Meier method and a subsequent multivariate analysis. Sixty-two patients with laryngeal granuloma were enrolled. An inhaled corticosteroid plus tranilast (300 mg/day) and rabeprazole (20 mg/day) were administered to all of the patients, and only to those diagnosed to have GERD, respectively. The size of granulomatous lesion was measured for each patient at the initial visit and every 4 weeks. At 48 weeks, the Kaplan-Meier plots for lesion disappearance rate were compared between groups with and without each of the etiological factors, followed by Cox proportional-hazards r...
Journal of voice : official journal of the Voice Foundation, Jan 5, 2016
To assess the angular velocity between the vocal folds just before the compression phase of throa... more To assess the angular velocity between the vocal folds just before the compression phase of throat clearing (TC) using high-speed digital imaging (HSDI) of the larynx. Twenty normal healthy adults (13 males and seven females) were enrolled in the study. Each participant underwent transnasal laryngo-fiberscopy, and was asked to perform weak/strong TC followed by a comfortable, sustained vowel phonation while recording an HSDI movie (4000 frames/s) of the larynx. Using a motion analysis, the changes in the vocal fold angle and angular velocity during vocal fold adduction were assessed. Subsequently, we calculated the average angular velocities in the ranges of 100-80%, 80-20%, and 20-0% from all of the angular changes. The motion analysis demonstrated that the changes in the angular velocity resulted in polynomial-like and sigmoid curves during TC and vowel phonation, respectively. The angular velocities during weak TC were significantly higher in the 20-0%, 80-20%, and 100-80% region...
Journal of voice : official journal of the Voice Foundation, Jan 11, 2015
The purpose was to assess whether cervical muscular contraction during phonation influences the p... more The purpose was to assess whether cervical muscular contraction during phonation influences the period and amplitude perturbation quotients (PPQ and APQ, respectively) of electroglottographic (EGG) signals, and whether high-pass filtering can attenuate these effects. Prospective. We included 19 nondysphonic speakers and 21 patients with muscle tension dysphonia. During the recording of acoustic and EGG signals, each participant was instructed to naturally phonate sustained vowels /i:/ and /a:/ (NP tasks), and additionally, each nondysphonic participant was asked to phonate the same vowels in a nondysphonic voice quality while contracting the cervical muscles (muscular contracted phonation [MCP] tasks). To confirm the contraction, surface and needle electromyography (EMG) was performed. The EGG signals were high-pass filtered at different cutoff frequencies from 0 to 90 Hz and were subsequently analyzed for the PPQ and APQ. Compared with the NP tasks, the MCP tasks enhanced the cervi...
Journal of voice : official journal of the Voice Foundation, 2014
To investigate the immediate effects of humming and subsequent um-hum phonation on the computed p... more To investigate the immediate effects of humming and subsequent um-hum phonation on the computed parameters of electroglottographic (EGG) signals in muscle tension dysphonia (MTD) patients and nondysphonic speakers. We included 21 MTD participants exhibiting both vocal roughness and supraglottic compression, who were able to produce successful humming and um-hum phonation. Twenty nondysphonic participants were selected as controls. Each participant was instructed to perform three phonatory tasks: natural phonation, humming phonation without pitch changes, and subsequent um-hum phonation, that is, humming with a pitch glide up as if agreeing with someone. Acoustic and EGG signals were recorded while the participants performed these tasks. Computed parameters reflecting the irregularities in vocal fold vibrations and the degree of glottal contact were calculated and compared between the tasks. The MTD group showed decreases in both perceptual vocal roughness and acoustic perturbation p...
OBJECTIVES This study aimed to assess the feasibility of gastroesophageal manometry for continuou... more OBJECTIVES This study aimed to assess the feasibility of gastroesophageal manometry for continuously evaluating the degree of expiratory effort by measuring the pressures in the digestive tract during crescendo phonation. METHODS Each of 18 healthy nondysphonic speakers had a probe with a four-channel gastroesophageal manometer inserted through the nasal cavity to place four pressure sensors in the hypopharynx, cervical-/thoracic esophagus, and stomach, and was asked to gradually increase the vocal loudness during sustained phonation of the vowel /e:/ (vowel-crescendo task), while the sound pressure level and the pressures were simultaneously recorded. RESULTS 50% of the successful vowel-crescendo task samples with a gradual and adequate sound pressure level increase showed a concomitant gradual increase in both the intra-thoracic-esophageal/intra-gastric pressure values from approximately -5 mmHg /6 mmHg to -10 mmHg/20 mmHg, respectively. The maximum pressure value was the highest in the intra-gastric pressure followed by the intra-thoracic-esophageal and intra-cervical-esophageal pressures in order. However, most of the samples showed less than one of atypical pressure changes, such as fluctuations in the intra-thoracic-esophageal and intra-gastric pressure changes and dispersion in the intra-cervical-esophageal and intra-hypopharyngeal pressure values (perhaps due to the peristaltic motions, and the contact of the sensors to the membranous wall). CONCLUSION These results show that, during successful crescendo phonation, gastroesophageal manometry reveals a gradual increase in the intra-thoracic and intra-abdominal pressures with increasing the vocal intensity, even though showing some systematic errors, suggesting the usefulness of gastroesophageal manometry for continuously evaluating the degree of expiratory effort without influence by the laryngeal condition.
【症例】77歳，女性。平成20年3月中旬から嗄声を自覚し，前医受診。喉頭腫瘍疑いにて4月上旬当科紹介受診。【治療前所見】右仮声帯の浮腫および右喉頭室の腫脹を認めた。CTでは甲状軟骨の内側に不自然... more 【症例】77歳，女性。平成20年3月中旬から嗄声を自覚し，前医受診。喉頭腫瘍疑いにて4月上旬当科紹介受診。【治療前所見】右仮声帯の浮腫および右喉頭室の腫脹を認めた。CTでは甲状軟骨の内側に不自然に空虚な領域を認めた。肺野条件下での冠状断CT所見では右傍声門間隙に気嚢胞を認め，内側型laryngoceleと診断した。【経過】再診時やや増大傾向を認めたため第7病日に入院し，第12病日に気管切開術およびラリンゴマイクロサージャリー下にて嚢胞開窓術を施行した。術中，嚢胞内部から少量の白色液とともに気泡の排出を確認した。【術後経過】術後1日目は右梨状窩から仮声帯にかけて比較的高度の浮腫を認めた。術後3日目にカニューレを抜去し，術後15日目で退院した。術後約2年のCTでは傍声門間隙に小結節影を認めるのみであり，現在のところ気嚢胞の再発を認めていない。【総括】ラリンゴマイクロサージャリー下での嚢胞開窓術は内側型laryngoceleに対して低侵襲かつ有効な術式である可能性を示唆する症例と考えられた。
Journal of voice : official journal of the Voice Foundation, Jan 10, 2016
The study aimed to investigate whether humming can immediately improve the regularity of vocal fo... more The study aimed to investigate whether humming can immediately improve the regularity of vocal fold vibration on electroglottography (EGG) and laryngeal high-speed digital imaging (HSDI) in patients with organic dysphonia (OD). In a series of 49 dysphonic patients who were diagnosed to have benign mass lesions in the vocal folds and an equal number of non-dysphonic speakers, perturbation parameters were calculated on the acoustic (Ac) and EGG signals during natural and humming phonation. In addition, 11 OD patients and as many non-dysphonic speakers underwent simultaneous EGG and HSDI video recording under laryngofiberscopy while performing the two tasks. The perturbation parameters of the EGG signals as well as the glottal area waveforms (GAW), which were extracted from the HSDI movies, were calculated, and the correlations between both perturbation parameters were analyzed. Humming achieved significant improvements in the EGG perturbation parameters in both groups. More than half ...
The present results indicate that the diagnosis of gastroesophageal reflux disease (GERD) is an i... more The present results indicate that the diagnosis of gastroesophageal reflux disease (GERD) is an independent etiological factor predicting retardation of the resolution of laryngeal granuloma. To assess the effects of combined usage of an inhaled corticosteroid plus tranilast and/or a proton pump inhibitor on the size of granulomatous lesions, and to reveal etiological factors related to the outcome using the Kaplan-Meier method and a subsequent multivariate analysis. Sixty-two patients with laryngeal granuloma were enrolled. An inhaled corticosteroid plus tranilast (300 mg/day) and rabeprazole (20 mg/day) were administered to all of the patients, and only to those diagnosed to have GERD, respectively. The size of granulomatous lesion was measured for each patient at the initial visit and every 4 weeks. At 48 weeks, the Kaplan-Meier plots for lesion disappearance rate were compared between groups with and without each of the etiological factors, followed by Cox proportional-hazards r...
Journal of voice : official journal of the Voice Foundation, Jan 5, 2016
To assess the angular velocity between the vocal folds just before the compression phase of throa... more To assess the angular velocity between the vocal folds just before the compression phase of throat clearing (TC) using high-speed digital imaging (HSDI) of the larynx. Twenty normal healthy adults (13 males and seven females) were enrolled in the study. Each participant underwent transnasal laryngo-fiberscopy, and was asked to perform weak/strong TC followed by a comfortable, sustained vowel phonation while recording an HSDI movie (4000 frames/s) of the larynx. Using a motion analysis, the changes in the vocal fold angle and angular velocity during vocal fold adduction were assessed. Subsequently, we calculated the average angular velocities in the ranges of 100-80%, 80-20%, and 20-0% from all of the angular changes. The motion analysis demonstrated that the changes in the angular velocity resulted in polynomial-like and sigmoid curves during TC and vowel phonation, respectively. The angular velocities during weak TC were significantly higher in the 20-0%, 80-20%, and 100-80% region...
Journal of voice : official journal of the Voice Foundation, Jan 11, 2015
The purpose was to assess whether cervical muscular contraction during phonation influences the p... more The purpose was to assess whether cervical muscular contraction during phonation influences the period and amplitude perturbation quotients (PPQ and APQ, respectively) of electroglottographic (EGG) signals, and whether high-pass filtering can attenuate these effects. Prospective. We included 19 nondysphonic speakers and 21 patients with muscle tension dysphonia. During the recording of acoustic and EGG signals, each participant was instructed to naturally phonate sustained vowels /i:/ and /a:/ (NP tasks), and additionally, each nondysphonic participant was asked to phonate the same vowels in a nondysphonic voice quality while contracting the cervical muscles (muscular contracted phonation [MCP] tasks). To confirm the contraction, surface and needle electromyography (EMG) was performed. The EGG signals were high-pass filtered at different cutoff frequencies from 0 to 90 Hz and were subsequently analyzed for the PPQ and APQ. Compared with the NP tasks, the MCP tasks enhanced the cervi...
Journal of voice : official journal of the Voice Foundation, 2014
To investigate the immediate effects of humming and subsequent um-hum phonation on the computed p... more To investigate the immediate effects of humming and subsequent um-hum phonation on the computed parameters of electroglottographic (EGG) signals in muscle tension dysphonia (MTD) patients and nondysphonic speakers. We included 21 MTD participants exhibiting both vocal roughness and supraglottic compression, who were able to produce successful humming and um-hum phonation. Twenty nondysphonic participants were selected as controls. Each participant was instructed to perform three phonatory tasks: natural phonation, humming phonation without pitch changes, and subsequent um-hum phonation, that is, humming with a pitch glide up as if agreeing with someone. Acoustic and EGG signals were recorded while the participants performed these tasks. Computed parameters reflecting the irregularities in vocal fold vibrations and the degree of glottal contact were calculated and compared between the tasks. The MTD group showed decreases in both perceptual vocal roughness and acoustic perturbation p...
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Papers by Kiyohito Hosokawa