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The cricoid plays 2 key roles: phonation and maintenance of the airway frame, both of which are lost in cases of comminuted cricoid fractures. The management of these 2 functions becomes a challenge in planning surgical treatment. We report the treatment course in a case of traumatic comminuted cricoid fracture that was resolved with good airway and phonatory functions. A 25-year-old man fell down the stairs and complained of respiratory discomfort and hoarseness of voice. A computed tomography scan showed comminuted cricoid fracture; therefore, surgery was performed to restore the patient's airway and phonation functions. We found that the airway was maintained by the anterior part and that the phonation depended on the posterior part of the cricoid. This novel concept helped clarify the treatment goal in this case of comminuted cricoid fractures. Furthermore, it is important that the anterior part of the cricoid is reconstructed with sufficient internal diameter, while the posterior part of the cricoid is reconstructed in the correct position. [ABSTRACT FROM AUTHOR]

The cartilage-conduction pathway was recently proposed as a third auditory pathway; however, middle-ear vibrations have not yet been investigated in vivo. We aimed to measure the ossicles and bone vibration upon cartilage-conduction stimulation with a non-contact laser Doppler vibrometer. We recruited adult patients with normal ear structures who underwent cochlear implant surgery at our hospital between April 2020 and December 2022. For sound input, a cartilage-conduction transducer, custom-made by RION Corporation (Tokyo, Japan), was fixed to the surface of the tragus and connected to an audiometer to regulate the output. A posterior tympanotomy was performed and a laser beam was directed through the cavity to measure the vibration of the ossicles, cochlear promontory, and posterior wall of the external auditory canal. Five participants (three men, mean age: 56.4 years) were included. The mean hearing loss on the operative side was 96.3 dB HL in one patient, and that of the other patients was off-scale. The vibrations were measured at a sound input of 1 kHz and 60 dB. We observed vibrations of all three structures, demonstrating the existence of cartilage-conduction pathways in vivo. These results may help uncover the mechanisms of the cartilage-conduction pathway in the future. [ABSTRACT FROM AUTHOR]

Purpose Thoracic endometriosis-related pneumothorax (TERP) is a secondary condition specific for females, but in a clinical setting, TERP often is difficult to distinguish from primary spontaneous pneumothorax (PSP) based on a relationship between the dates of pneumothorax and menstruation. The purpose of this study was to clarify the clinical features of TERP compared with PSP. Methods We retrospectively reviewed the clinical and histopathological files of female patients with pneumothorax who underwent video-assisted thoracoscopic surgery in the Pneumothorax Research Center during the 6-year period from January 2005 to December 2010. We analyzed the clinical differences between TERP and PSP. Results The study included a total of 393 female patients with spontaneous pneumothorax, of whom 92 (23.4 %) were diagnosed as having TERP and 33.6 % (132/393) as having PSP. We identified four factors (right-sided pneumothorax, history of pelvic endometriosis, age [greater than or equal to]31 years, and no smoking history) that were statistically significant for predicting TERP and assigned 6, 5, 4, and 3 points, respectively, to establish a scoring system with a calculated score from 0 to 18. The cutoff values of a calculated score [greater than or equal to]12 yielded the highest positive predictive value (86 %; 95 % confidence interval (CI) 81.5-90.5 %) for TERP and negative predictive value (95.2 %; 95 % CI 92.3-98 %) for PSP. Conclusions TERP has several distinct clinical features from PSP. Our scoring system consists of only four clinical variables that are easily obtainable and enables us to suspect TERP in female patients with pneumothorax., Author(s): Takahiro Haga[sup.1] [sup.2] [sup.5] , Hideyuki Kataoka[sup.1] [sup.5] , Hiroki Ebana[sup.1] [sup.3] [sup.4] [sup.5] , Mizuto Otsuji[sup.1] [sup.4] [sup.5] , Kuniaki Seyama[sup.3] [sup.5] , Koichiro Tatsumi[sup.2] , Masatoshi Kurihara[sup.1] [...]

Introduction: Transoral surgery for head and neck cancer provides excellent oncologic outcomes while preserving speech and swallowing function. When neck dissection and resection of oropharynx are performed concomitantly, there is a risk of creating a communication defect or developing a pharyngocutaneous fistula. To prevent pharyngocutaneous fistula, we performed the reconstruction using a posteriorly based lateral tongue flap for communication defect. Patient: A 72-year-old male with oropharyngeal cancer (tonsil cancer) T2N1M0 underwent concomitant transoral videolaryngoscopic surgery and neck dissection. The lateral wall of the oropharynx was resected with the pharynx constrictor muscle and parapharyngeal fat due to infiltration of the parapharyngeal space by the tonsil cancer. The posteriorly based lateral tongue flap was used to close the perforation. There was no leakage to the neck postoperatively. The patient had no problem with phonation or oral intake and remained free of disease at 12 months after treatment. Conclusion: For a small defect confined to the oropharyngeal lateral wall, the posteriorly based lateral tongue flap should be considered as a useful option for reconstruction of the oropharynx without impairment of posterior function. [ABSTRACT FROM AUTHOR]

Summary: The fundamental frequency of vocal fold oscillation ([F.sub.0]) is controlled by laryngeal mechanics and aerodynamic properties. [F.sub.0] change per unit change of transglottal pressure (dF/dP) using a shutter valve [...]