: Objective. Predicting the correct singing voice classification based on laryngoscopy is an old myth. The aim of this study was to evaluate if a professional phoniatrician/laryngologist can predict the correct singing voice classification only from laryngoscopy and to analyze different anatomical parameters between professional sopranos and altos to determine whether a multivariate analysis of anatomical parameters can predict the singing register.Study design. Prospective studyMethods. We included 49 professional female singers (25 sopranos, 24 altos). Laryngoscopic images were shown to professional phoniatricians/laryngologists to rate whether it they show a soprano or an alto. In addi-tion, a high-resolution computer tomography (HRCT) scan was performed during singing of integral 0 by each singer. DICOM scan data were rendered and 3D-visualized using the software MIMICS. In all singers, we measured the length of the vocal folds of the glottis, the distance from the anterior commissure orthogonally to the vertebral spine, and the antero-posterior distance of the subglottis/trachea 1 cm and 2 cm below the glottis. We also mea-sured the length and volume of the resonance space. Results. It was not possible to predict the singing voice classification only from laryngoscopy. In the HRCT images, sopranos had significantly shorter vocal folds, a shorter glottal length, a shorter distance from the ante-rior commissure to the spine, and a shorter resonance space. When combining all parameters, the chance of cor-rectly predicting a soprano was 74.1% and an alto 68.2%. Conclusion. Although there are anatomical differences between sopranos and altos, prediction of the singing voice classification from laryngoscopy or HRCT is not reliable enough for clinical use.

Nasal surface anesthesia is a simple, non-invasive method with a not yet fully understood effect on oral tissues. Should it prove to be successful in dental medicine, it could replace or at least complement the more invasive injection anesthesia, especially in children after dental trauma. The local anesthetic Tenaphin (tetracaine hydrochloride and naphazoline nitrate) was applied to 105 patients prior to ear, nose and throat medical diagnosis or therapy. After different exposure times, the influence on the oral tissues in the anterior region was examined by a dentist in the context of a pilot study. The effect of the mucosal anesthesia increased in the canine and anterior region the further mesial the tooth was located and the longer the application time was. In the buccal and palatinal area the effect increased from apical to incisal. The pulps of the central incisors and the canines were better anesthetized than those of the lateral incisors. Nasal surface anesthesia has the potential to replace the more invasive injection anesthesia in the anterior region of the upper jaw or to complement it. Dosage and exposure time will have to be investigated in more detail.

OBJECTIVE:Vocal folds are widely assumed to only elongate to raise vocal pitch. However, the mechanisms seem to be more complex and involve both elongation and tensioning of the vocal folds in series. The aim of the present study was to show that changes in vocal fold morphology depend on vocal fold elongation and tensioning during singing.STUDY DESIGN:This was a prospective study.METHODS:Forty-nine professional female singers (25 sopranos, 24 altos) were recruited and three-dimensional laryngeal images analyzed in a coronal view derived from high-resolution computed tomography scans obtained at the mean speaking fundamental frequency (ƒ0) and one (2ƒ0) and two octaves (4ƒ0) above ƒ0.RESULTS:The vocal fold angle, defined by a tangent above and below the vocal folds, was 58° at ƒ0, 47° at 2ƒ0, and 59° at 4ƒ0.CONCLUSION:The decreased caudomedial angle of the vocal fold from ƒ0 to 2ƒ0 (change in muscle belly from ";fat" to "thin") and increased angle from 2ƒ0 to 4ƒ0 (from "thin" to "fat") strongly supports the hypothesis that the vocal folds elongate and then tension when singing from ƒ0 to 4ƒ0. This is the first study to show this relationship in vivo.

Continuing Medical EducationCME-ORL 4/AuflösungTiefzervikale Schwellung rechtsStorck and HusnerStorck HNO-Klinik, Universitätsspital Basel Search for more papers by this author and Husner HNO-Klinik, Universitätsspital Basel Search for more papers by this authorPublished OnlineDecember 20, 2012https://doi.org/10.1024/1661-8157/a000831PDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInReddit SectionsMoreFiguresReferencesRelatedDetails Volume 101Issue 4February 2012ISSN: 1661-8157eISSN: 1661-8165 tabs.informationPraxis (2012), 101, pp. 275-277 https://doi.org/10.1024/1661-8157/a000831.© 2012Hogrefe AGPDF download

Continuing Medical EducationCME-ORL 1Zervikale RaumforderungStorckStorck HNO-Klinik, Universitätsspital Basel Search for more papers by this authorPublished Online:January 09, 2013https://doi.org/10.1024/1661-8157/a000477PDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInReddit SectionsMoreFiguresReferencesRelatedDetails Volume 100Issue 4February 2011ISSN: 1661-8157eISSN: 1661-8165 InformationPraxis (2013), 100, pp. 201-202 https://doi.org/10.1024/1661-8157/a000477.© 2013Hogrefe AGPDF download

Continuing Medical EducationCME-ORL 3/AuflösungZervikale Schwellung rechtsGebhardt and StorckGebhardt HNO-Klinik, Universitätsspital Basel Search for more papers by this author and Storck HNO-Klinik, Universitätsspital Basel Search for more papers by this authorPublished Online:January 09, 2013https://doi.org/10.1024/1661-8157/a000682PDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInReddit SectionsMoreFiguresReferencesRelatedDetails Volume 100Issue 18September 2011ISSN: 1661-8157eISSN: 1661-8165 InformationPraxis (2013), 100, pp. 1130-1131 https://doi.org/10.1024/1661-8157/a000682.© 2013Hogrefe AGPDF download

Introduction. Arytenoid adduction is a very effective procedure for medializing the posterior part of the vocal fold in vocal fold paralysis. Major drawback of the method is the technically sometimes-difficult access to the arytenoid with increased postoperative morbidity. Aim of this study was to provide basic anatomical data regarding the accessibility of the arytenoid cartilage through a thyroplasty window. Furthermore, to investigate the feasibility of an arytenoid adduction by fixation of a surgical screw to the arytenoid cartilage by using this approach.Materials and methods. 10 cadaver larynges, six female and four male, were dissected and measured for our points of interest. A standard manufacture-made surgical screw attached to a suture was anchored to the fovea oblonga of the arytenoid cartilage.Results. Our anatomical measurements proved a mean distance from the posterior edge of the thyroid window to the arytenoid of about 8-9 mm in male larynges and 7-8 mm in female larynges. The distances did not differ significantly between the sexes. Pulling the anchored surgical screw medializes the posterior part of the vocal fold.Discussion. Our data showed that there is a very constant morphometric relation between the thyroplasty window and the arytenoid cartilage. It is known that gender-related differences result in a veritable laryngeal dimorphism in nearly all absolute laryngeal dimensions. These differences appear to a much lesser extend in the distances from the surface to the depth, as was confirmed in our series. Using these findings led us to identification of the fovea oblonga near the muscular process as the most favorable point for fixation of a surgical screw through a conventional thyroplasty window. Pulling the attached suture medializes the arytenoid cartilage.

Vocal cord granulomas are benign inflammatory lesions of the vocal cords. They are usually located over the vocal process of the arytenoid cartilage. A corresponding ulcer on the contralateral side is a common finding. Clinical signs include foreign body sensation, a need to repeatedly clear one's throat, hoarseness, and reduced voice resilience. Voice abuse and gastro-oesophageal reflux are commonly cited important aetiological factors. Differentiation from malignant lesions is usually possible by history and clinical examination; biopsy is only rarely necessary. The primary treatment is speech therapy or voice counselling, if necessary, supported by antacids. Surgical excision is not helpful because contact granulomas tend to recur. We present two typical cases of vocal cord granulomas and discuss their management.

Vocal cord granulomas are benign inflammatory lesions of the vocal cords. They are usually located over the vocal process of the arytenoid cartilage. A corresponding ulcer on the contralateral side is a common finding. Clinical signs include foreign body sensation, a need to repeatedly clear one’s throat, hoarseness, and reduced voice resilience. Voice abuse and gastro-oesophageal reflux are commonly cited important aetiological factors. Differentiation from malignant lesions is usually possible by history and clinical examination; biopsy is only rarely necessary. The primary treatment is speech therapy or voice counselling, if necessary, supported by antacids. Surgical excision is not helpful because contact granulomas tend to recur. We present two typical cases of vocal cord granulomas and discuss their management.

Soziale Benachteiligung geht mit psychosozialen Belastungen einher, die zu Gesundheitsrisiken bei Kindern und Jugendlichen führen. Im Zentrum von Präventionsbemühungen sollten soziale Gruppen stehen, die gesundheitsfördernde Maßnahmen am stärksten benötigen. Diese sind jedoch in der Praxis schwer zu erreichen.

Granularzelltumoren (GZT) sind subkutan oder submukös gelegene, gutartige Tumoren neurogenen Ursprungs. Sie treten häufig im Kopf-Hals-Bereich auf, insbesondere in der Zunge. Bisher wurden etwa 200 laryngeale GZT beschrieben. Meist sind dabei die Stimmlippen und die posteriore Glottis betroffen. Eine Unterscheidung von einer chronischen Entzündung oder einem Malignom ist nur mittels Biopsie möglich. Als Therapie der Wahl wird die vollständige Exzision empfohlen, wobei Tumorausdehnung und zu erwartende Morbidität die Radikalität des Vorgehens bestimmen. Bei vollständiger Entfernung sind Rezidive selten.

Background. Social disadvantages are accompanied by psychosocial strain, which leads to different health risks for children and adolescents. Children with lower psychosocial resources have a higher risk of illness. Therefore, prevention and health promotion should concentrate on specific target groups. These are, however, difficult to address.Methods. This paper examines to what extent the programme Klasse2000 reaches elementary school classes from deprived areas and how the programme is accepted. The database is a national survey of participating teachers (n=3,756).Results. Twenty-four percent of the teachers stated that their school is situated in a deprived area. The results show high acceptance and practicability in this target group. Teachers in deprived areas judged the curriculum more positively than their colleagues did. The groups did not differ with respect to coverage and fidelity of implementation.Conclusion. The results indicate that life skills training with Klasse2000 is accepted and is being successfully implemented by teachers of elementary schools in deprived areas.