A Contemporary View of Tracheoesophageal Voice Restoration

2012 ◽  
Vol 22 (1) ◽  
pp. 33-44
Author(s):  
Jodi K. Knott ◽  
Jan S. Lewin
Keyword(s):  
Total Laryngectomy ◽  
Postoperative Recovery ◽  
Daily Routine ◽  
Geographical Distance ◽  
Specialized Knowledge ◽  
Voice Restoration ◽  
Treatment Regimens ◽  
The Past ◽  
Contemporary View ◽  
Rehabilitative Services

Voice restoration following total a laryngectomy has evolved over the past several decades. The patient who undergoes a total laryngectomy with tracheoesophageal (TE) puncture moves through several phases of treatment during their postoperative recovery and vocal restoration. The method of TE puncture is relatively simple; however, TE voice restoration is often complicated by the challenges associated with more intensive cancer treatment regimens, the geographical distance that impedes access to rehabilitative services, and myriad available products that require specialized knowledge and experience. In this article, we will provide a contemporary view of TE voice restoration, including its challenges for patients and clinicians. In addition, we will discuss the speech-language pathologist's role in the patient's rehabilitation, from providing evaluation and instruction regarding voice restoration and care of the stoma to ensuring the patient's transition back into their normal daily routine.

Reasons for success or failure in surgical voice restoration after total laryngectomy: an Australian study

2001 ◽  
Vol 115 (5) ◽  
pp. 393-399 ◽  
Author(s):  
Jacqui Frowen ◽  
Alison Perry
Keyword(s):  
Total Laryngectomy ◽  
Quantitative Research ◽  
Patient Management ◽  
Success Rates ◽  
Australian Study ◽  
Voice Restoration ◽  
The Past ◽  
Speech Rehabilitation ◽  
Acute Hospitals ◽  
Future Patient

Over the past 20 years, use of tracheo-oesophageal puncture (TEP) speech after total laryngectomy has resulted in reported success rates of 90-93 per cent worldwide. Despite this, data collected from major acute hospitals in Victoria, Australia indicated that, of 38 patients who underwent total laryngectomy in 1997, only 10 (26 per cent) were using TEP speech as their primary mode of communication at 12 months post-operatively. This paper describes how a quantitative research methodology was used to investigate why so few patients in Victoria were successfully using TEP speech as their chosen mode of rehabilitation after total laryngectomy. Patients, speech pathologists and ENT surgeons were interviewed. Their thoughts and beliefs regarding speech rehabilitation were mapped, and themes were identified, coded and analysed. This paper describes and discusses the results of this research and its possible implications for future patient management, through establishing a model for ‘ideal’ speech rehabilitation.

Endovenous procedures in varicose veins

Phlebologie ◽  
2008 ◽  
Vol 37 (05) ◽  
pp. 229-236
Author(s):  
N. Cayne ◽  
G. Jacobowitz ◽  
P. Lamparello ◽  
T. Maldonado ◽  
C. Rockman ◽  
...  
Keyword(s):  
Varicose Veins ◽  
Treatment Options ◽  
Postoperative Recovery ◽  
Comparable Efficacy ◽  
Intense Pulse Light ◽  
Efficacy And Safety ◽  
Endovenous Laser Ablation ◽  
The Past ◽  
Early Evidence ◽  
Endovenous Treatment

SummaryOver the past ten years endoveous treatment options for varicose veins have evovled considerably, offering clinicians a multitude of options to meet the needs of their patients. The endothermal ablation procedures have moved to the forefront as the choice modality for treating truncal reflux. Both radiofrequency ablation and endovenous laser ablation are widely accepted and interchangeable, showing comparable efficacy and safety. Although numerous endovenous laser wavelengths exist, the data indicates that the differences do not affect the efficacy or postoperative recovery of the procedure. The endovenous laser innovation that has shown early evidence of improved patient outcome is the jacket-tip fiber. The versatility of sclerotherapy makes it a critical component in the endovenous treatment of varicosities. Although not approved by the Food and Drug Administration (USA), the use of a foamed sclerosing agent is the fastest growing segment of sclerotherapy and an important treatment modality in the future of varicose vein treatment. Cutaneous lasers and intense pulse light devices contribute a crucial element, enabling clinicians to treat minute veins that may be impossible to treat with other therapies.

TARP DVIEJŲ KOLONŲ: XVIII A. PABAIGOS – XIX A. PRADŽIOS VILNIAUS MASONŲ KASDIENYBĖ SIMBOLIKOJE

2018 ◽  
pp. 144-163
Author(s):  
Daiva Milinkevičiūtė
Keyword(s):  
Daily Life ◽  
The Other ◽  
Daily Routine ◽  
The Past ◽  
Secular World ◽  
National Characteristics ◽  
Conservative Christian ◽  
The Subject ◽  
The One ◽  
Craft Guilds

The Age of Enlightenment is defined as the period when the universal ideas of progress, deism, humanism, naturalism and others were materialized and became a golden age for freemasons. It is wrong to assume that old and conservative Christian ideas were rejected. Conversely, freemasons put them into new general shapes and expressed them with the help of symbols in their daily routine. Symbols of freemasons had close ties with the past and gave them, on the one hand, a visible instrument, such as rituals and ideas to sense the transcendental, and on the other, intense gnostic aspirations. Freemasons put in a great amount of effort to improve themselves and to create their identity with the help of myths and symbols. It traces its origins to the biblical builders of King Solomon’s Temple, the posterity of the Templar Knights, and associations of the medieval craft guilds, which were also symbolical and became their link not only to each other but also to the secular world. In this work we analysed codified masonic symbols used in their rituals. The subject of our research is the universal Masonic idea and its aspects through the symbols in the daily life of the freemasons in Vilnius. Thanks to freemasons’ signets, we could find continuity, reception, and transformation of universal masonic ideas in the Lithuanian freemasonry and national characteristics of lodges. Taking everything into account, our article shows how the universal idea of freemasonry spread among Lithuanian freemasonry, and which forms and meanings it incorporated in its symbols. The objective of this research is to find a universal Masonic idea throughout their visual and oral symbols and see its impact on the daily life of the masons in Vilnius. Keywords: Freemasonry, Bible, lodge, symbols, rituals, freemasons’ signets.

scholarly journals Dermoscopy revealing a case of Tinea Nigra*

2013 ◽  
Vol 88 (1) ◽  
pp. 128-129 ◽  
Author(s):  
Paulo Ricardo Criado ◽  
Lívia Delgado ◽  
Gustavo Alonso Pereira
Keyword(s):  
Infectious Diseases ◽  
Diagnostic Tool ◽  
Glabrous Skin ◽  
Daily Routine ◽  
Brown Patch ◽  
The Past ◽  
History Of ◽  
Tinea Nigra ◽  
Skin Conditions

Dermoscopy has being used over the past twenty years as a noninvasive aid in the diagnosis of innumerable skin conditions, including infectious diseases and infestations (Entodermoscopy).Tinea nigra is a superficial phaeohyfomycosis that affects mainly the glabrous skin of palms and soles. We describe a 14 year-old girl with a three-month history of an enlarging brown patch of her hand diagnosed as Tinea Nigra following clinical and dermoscopy examination.These images emphasize the importance of dermoscopy as a diagnostic tool in the daily routine of dermatologists.

scholarly journals Antiviral therapy of chronic hepatitis C: 30 years success story

2019 ◽  
Vol 91 (11) ◽  
pp. 110-115
Author(s):  
D T Abdurakhmanov ◽  
T P Rozina ◽  
E N Nikulkina ◽  
E Z Burnevich ◽  
E L Tanashuk ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Antiviral Therapy ◽  
Chronic Hepatitis C ◽  
Antiviral Action ◽  
Success Story ◽  
Treatment Regimens ◽  
The Past ◽  
C 30

Exactly 30 years ago, hepatitis C virus was identified. Over the years, tremendous success has been achieved in the treatment of hepatitis C, which is currently considered to be an almost completely curable disease. The review presents the main stages in the development of hepatitis C antiviral therapy, the efficacy of various treatment regimens. The greatest progress in treatment was noted over the past 5 years when drugs with direct antiviral action appeared and began to be widely used, including in Russia, which ensure the elimination of the virus in 90-95% of cases.

Kant's Theological Constructivism

1993 ◽  
Vol 86 (3) ◽  
pp. 323-351 ◽  
Author(s):  
Adina Davidovich
Keyword(s):  
Immanuel Kant ◽  
Daily Routine ◽  
Abstract Thinking ◽  
Will To Power ◽  
Liberal Theology ◽  
The Past ◽  
Central Elements ◽  
Better Than

Our generation celebrates its freedom from the constricting yoke of the imperial age of grand systems. It joyfully rebels against abstract thinking and disavows preoccupation with systematicity, which none epitomized better than Immanuel Kant, according to whose daily routine the women of Königsberg allegedly set their clocks. Contemporary liberal theology claims that we can no longer believe in a universal disembodied reason that is free from the constraints of particular circumstances. Our thinking, it alleges, reflects interests and desires. Theories serve our will to power and are to be interpreted not by appeal to an aloof rationality, but through analysis of our needs and inclinations. Freedom, however, produces new trepidations. Confronted with radical implications of their convictions, very few are willing to regard their theologies as relatively valid. Tending to reject the past yet wary of anarchy, contemporary liberal theology seeks a method that is attuned to contingent circumstances and avoids the pitfalls of unbridled relativism. I suggest that in our haste to defy and overthrow past masters, we deprive ourselves of profound insights that could guide a quest for resolution. As a case in point, I propose that if we are willing to look afresh at Kant and explore central elements of his system that have been obscured by an overzealous portrayal of his thought as a rigoristic abstract formalism, we shall find clues for escaping the impossible choice between absolutism and relativism.

Effect of primary, cross-over, zigzag neopharyngoplasty on acoustic characteristics of alaryngeal, tracheoesophageal voice

2011 ◽  
Vol 125 (8) ◽  
pp. 841-848 ◽  
Author(s):  
O A Albirmawy
Keyword(s):  
Total Laryngectomy ◽  
Dynamic Range ◽  
Speaking Rate ◽  
University Hospital ◽  
Pharyngocutaneous Fistula ◽  
Acoustic Parameters ◽  
Tertiary Referral Centre ◽  
Voice Restoration ◽  
Fundamental Frequencies ◽  
Temporal Measures

AbstractObjective:To evaluate the effect of primary, cross-over, zigzag neopharyngeal construction on tracheoesophageal voice, compared with pharyngoesophageal myotomy, following total laryngectomy with partial pharyngectomy.Study design:Prospective clinical trial.Setting:Otolaryngology department, Tanta University Hospital (tertiary referral centre), Egypt.Patients and methods:Over five years, 30 patients underwent total laryngectomy with partial pharyngectomy to manage stage III or IV laryngeal cancer, followed by primary tracheoesophageal puncture for voice restoration. For neopharyngeal construction, 15 patients underwent pharyngoesophageal myotomy (group one) and 15 cross-over, zigzag neopharyngoplasty (group two). Acoustic parameters of tracheoesophageal voice were compared.Results:Most acoustic parameters were almost equivalent for the two groups, although significant differences were seen for loud intensity, dynamic range, shimmer, loud fundamental frequency, loud jitter, fluency and speaking rate. One post-operative pharyngocutaneous fistula (6.6 per cent) occurred in each group, and resolved with conservative measures.Conclusion:The cross-over neopharyngoplasty modification of hypopharyngeal closure may help avoid pharyngoesophageal spasm and assist maintenance of effective voice amplitude, fundamental frequencies, temporal measures and perceptual values.

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