New procedure to fix damaged vocal cords to give people their voice back

Imagine not being able to speak above a whisper. For one woman, it was a reality for 35 years, but she regained her voice, with help from jet engines.

Picking up the phone, or placing an order. Is something Jan Christian hasn't been able to do for decades.

At just 17, a car accident robbed her of her voice. Jan's throat hit the dashboard, crushing her larynx. After that, she barely spoke above a whisper.

Jan Christian, Lost Voice, describes what she sounded like for years, “I sounded like the girl in the Exorcist."

Sid Khosla, MD, University Hospital Cincinnati Assistant Professor, UC Department of Otolaryngology-Head and Neck Surgery Director, UC Health Professional Voice Center, describes her condition when he first met her, "She was completely what you call euphonic. She was talking like that (whispers), and you don't know if that's something you can fix or not."

Normal vocal cords in action usually come together and vibrate to produce sound.

In Jan's case, the cords were so severely crushed, they couldn't join together. To rebuild them, Doctor Sid Khosla took what he knew about throat cancer patients and coupled it with his research on jet engines and flow patterns.

Dr. Khosla, MD, describes the connection between jet engines and vocal cords, "The flow has these things called vertices which are areas of rotational motion. And from aerospace, from jet engines we know that the vertices can cause sound."

Those principles enabled Doctor Khosla to build new cords with lining from Jan's cheek and a laser to stiffen them, so they could come together and vibrate.

While still not perfect, words can't describe how thankful Jan is to have her voice back.

Christian describes her reaction when she had her voice back, "I just, I mean I broke down in tears because I never thought there was a possibility."

This possibility for Jan Christian was 35 years in the making.

Jan's now working with a speech therapist to get her voice even stronger.

Doctor Khosla has performed the first of several surgeries, similar to Jan's, on a 16 year old girl whose throat was crushed when a 750 pound basketball hoop fell on her.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY

TOPIC: JET ENGINES HELP SAVE JAN'S VOICE
REPORT: MB # 3414

THE WORKS OF THE VOCAL CORDS: What is the human voice made of? Very simply- the muscles of the larynx, air, space and the articulators (tongue, teeth, palate, lips). These components interact with each other to produce your unique vocal sound. Voice is produced by vibration of the vocal folds. The vocal folds are a pair of pliable shelves of tissue that stretch across the top of the trachea. They are enclosed within the thyroid cartilage, which is the hard structure that forms the mass in the neck known as the Adam's apple. The vocal folds, together with the muscles and cartilages that support them, are known as the larynx. ( Source: ( Voicemedicine.com)

BACKGROUND: The larynx, also known as the voice box, is located in the neck and plays a crucial role in speech and breathing. It has three important functions including; control of the airflow during breathing, protection of the airway, and production of sound for speech. Larynx injuries account for only 1 in every 22,900 emergency room visits each year. Although rare, larynx injuries can result in serious problems including impairment of voice production and difficulty breathing.
(Sources: www.evmsent.org, www.utmb.edu)

INJURIES: Symptoms of larynx injuries include difficulty breathing, difficulty speaking, difficulty swallowing, and hoarseness. (Source: www.utmb.edu). Although injury to the laryngeal nerves is uncommon it can occur from car accidents, neck or chest surgery complications, breathing tube complications, viral infections that affect the nerves, and tumors in the neck or upper chest. (Source: www.health.nytimes.com)

TREATMENT: Treatments for larynx injuries vary depending on the cause of the injury. In some cases, no surgery may be needed and the nerve may recover on its own. In the case that surgery is needed, doctors attempt to change the position of the paralyzed vocal cord to improve the voice. This can be done with; arytenoid adduction (stitches to move the vocal cord toward the middle of the airway), injections of collagen, or gel foam. Jet engines have provided insight into the flow patterns of the human voice and have helped give some patients their voices back. Vortices may help explain why individual voices are different and can have a different richness and quality to their sound. According to Doctor Sid Khosla, when surgery is required to treat voice disorders, it's primarily done on the vocal cord. He also says, knowing there are additional sources that affect sound may open up a whole new way for us to treat voice disorders (Source: health.nytimes.com, UC Health News)

FOR MORE INFORMATION, PLEASE CONTACT:

Sid Khosla, MD
UC Health Professional Voice Center.
khoslasm@ucmail.uc.edu


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