In the last decade, the implementation of machine learning algorithms in the analysis of voice disorder is paramount in order to provide a non-invasive voice pathology detection by only using audio signal. In spite of that, most recent systems of voice pathology work on a limited acoustic database. In other words, the systems use one vowel, such as /a/, and ignore sentences and other vowels when analyzing the audio signal. Other key issues that should be considered in the systems are accuracy and time consumption of an algorithm. Online Sequential Extreme Learning Machine (OSELM) is one of the machine learning algorithms that can be regarded as a rapid and accurate algorithm in the classification process. Therefore, this paper presents a voice pathology detection and classification system by using OSELM algorithm as a classifier, and Mel-frequency cepstral coefficient (MFCC) as a featured extraction. In this work, the voice samples were taken from the Saarbrücken voice database (SVD). This system involves two parts of the database; the first part includes all voices in SVD with sentences and vowels /a/, /i/, and /u/, which are uttered in high, low, and normal pitches; and the second part utilizes voice samples of the common three types of pathologies (cyst, polyp, and paralysis) based on the vowel /a/ that is produced in normal pitch. The experimental results have shown that OSELM was able to achieve the highest accuracy up to 91.17%, 94% of precision, and 91% of recall. Furthermore, OSELM obtained 87%, 87.55%, and 97.67% for f-measure, G-mean, and specificity, respectively. The proposed system also presents a high ability to achieve detection and classification results in real-time clinical applications.

Laryngeal reinnervation for bilateral vocal fold paralysis (BVFP) patients is a promising technique to achieve good airway, although preserving a good quality of voice. On the other hand, the procedure is not simple. This review explores the recent literature on surgical technique and factors that may contribute to the success. Research and literature in this area are limited due to variability and complexity of the nerve supply. The posterior cricoarytenoid (PCA) muscle also receives nerve supply from the interarytenoid branch. Transection of this nerve at the point between interarytenoid and PCA branch may prevent aberrant reinnervation of adductor nerve axons to the PCA muscle. A varying degree of regeneration of injured recurrent laryngeal nerves (RLN) in humans of more than 6 months confirms subclinical reinnervation, which may prevent denervation-induced atrophy. Several promising surgical techniques have been developed for bilateral selective reinnervation for BVFP patients. This involves reinnervation of the abductor and adductor laryngeal muscles. The surgical technique aims at reinnervating the PCA muscle to trigger abduction during the respiratory cycle and preservation of good voice by strengthening the adductor muscles as well as prevention of laryngeal synkinesis.

Objective: To determine the sensitivity and specificity of intensive empirical treatment with pantoprazole in diagnosing laryngopharyngeal reflux in adults.Study design: This was a prospective, double-blind study.Subjects and methods: Fifty-five patients with either a Reflux Symptom Index of more than 13 or a Reflux Finding Score of more than 7 were enrolled. All patients underwent 24-hour, double-probe pH monitoring before commencing pantoprazole 40 mg twice daily; both investigators and patients were blinded to pH monitoring results. The Reflux Symptom Index and Reflux Finding Score were reassessed during the second, third and fourth month of follow up.Results: The sensitivity of empirical pantoprazole treatment in diagnosing laryngopharyngeal reflux was 92.5 per cent. The specificity was 14.2 per cent, the positive predictive value 86 per cent and the negative predictive value 25 per cent. There was significant reduction in the total Reflux Symptom Index and Reflux Finding Score after the second, third and fourth month of treatment. There was no correlation between laryngopharyngeal reflux and body mass index.Conclusion: Our results suggest that intensive empirical treatment with proton pump inhibitors is effective in diagnosing laryngopharyngeal reflux.

A systematic review on laryngopyoceles across Ovid, PubMed, and Google Scholar database was conducted. A total of 61 papers published between 1952 and 2015 were found. Of these, 23 cases written in English, which described the number of cases, surgical approaches, resort to tracheostomy, complications, and outcomes, were shortlisted. Four cases of laryngopyoceles were managed endoscopically using a cold instrument, microdebrider, or laser. Eighteen cases were operated via an external approach, and 1 case applied both approaches. One of 4 endoscopic and 10 of 18 external approaches involved tracheostomy. The present study aimed to report a case of large mixed laryngopyocele that was successfully drained and marsupialized endoscopically using suction diathermy without requiring tracheostomy. Management using suction diathermy for excision and marsupialization of a laryngopyocele has never been reported and can be recommended as a feasible method due to its widespread availability. In the presence of a large laryngopyocele impeding the airway, tracheostomy may be averted in a controlled setting. None specified.