Ann Oto Rhinol Laryn
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The present investigation examined the effects of sickle cell anemia on threshold hearing. The study included 43 homozygous sickle cell anemia patients, ages 7-18 years, and 23 age-matched controls with documented normal hemoglobin. Both the study and control groups received otologic and audiologic examinations. ⋯ The sickle cell group, therefore, exhibited a higher than usual incidence of hearing loss. Further, three of the five subjects with hearing loss evidenced central nervous system involvement, resulting in a probability of < 0.025 that this relation might occur by chance. Periodic hearing evaluations of children with sickle cell anemia should be performed to identify those with auditory complications and those who possibly may have CNS involvement.
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Sarcoidosis is a chronic systemic granulomatous disease that occasionally affects the larynx. When the degree of involvement is marked, significant airway obstruction can occur. ⋯ The clinical features of sarcoidosis of the larynx are discussed, and current methods of treatment are summarized. The laryngologist should include laryngeal sarcoidosis in the differential diagnosis of patients with airway obstruction, and should play a major role in its management.
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Botulism is a serious intoxication caused by ingestion of food containing preformed botulinus toxin and characterized by rapidly progressive bulbar paralysis, generalized weakness, and respiratory insufficiency. In 1976 a distinct clinical entity of infant botulism was recognized. The disease apparently results from intraintestinal toxin production which produces a defect in neuromuscular transmission by interfering with release of acetylcholine at cholinergic synapses. ⋯ The effectiveness of antitoxin or antibiotics to treat infant botulism remains questionable and therefore prolonged respiratory supportive care is the mainstay of therapy. In addition, we offer guidelines for decannulation in cases of infant botulism. None of the patients in our series could be decannulated prior to initial discharge from the hospital.
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Ann Oto Rhinol Laryn · Jan 1979
Cricothyroid distance and vocal pitch. Experimental surgical study to elevate the vocal pitch.
To establish an experimental basis for surgical approximation of the anterior cricothyroid distance which aims at raising the vocal pitch, the relationship between vocal pitch and the cricothyroid distance was analyzed in voices produced with excised human larynges (four male and two female larynges). Within the framework of the experimental conditions, the following conclusions were drawn: 1) The vocal pitch expressed in semitones was almost linearly related to the cricothyroid distance, with an increase of 0.15 to 0.90 semitones per milimeter of cricothyroid approximation. 2) The rise in vocal pitch reached a plateau when the force applied to shorten the cricothyroid distance reached 30 to 50 gm.