The purpose of this study was to investigate early radiation effects on tongue function for patients with nasopharyngeal carcinoma (NPC) and to provide a scientific database for early intervention plans. Twelve subjects with NPC and 12 age- and sex-matched normal subjects were included. Tongue maximum isometric strength and endurance at 50% of maximum strength were obtained once from normal subjects with the Iowa Oral Performance Instrument (IOPI) and twice from the NPC subjects: before and 2 months after radiation treatment. No significant differences were found in tongue function evaluation for normal or NPC groups in either pre- or post-treatments. However, this study showed that significant decreases in tongue function may not start until 2 months after treatment.

Viridians streptococcal shock syndrome is a subtype of toxic shock syndrome. Frequently, the diagnosis is missed initially because the clinical features are nonspecific. However, it is a rapidly progressive disease, manifested by hypotension, rash, palmar desquamation, and acute respiratory distress syndrome within a short period. The disease course is generally fulminant and rarely presents initially as a purpura over the plantar region. We present a case of a 54-year-old female hospital worker diagnosed with viridians streptococcal shock syndrome caused by Streptococcus gordonii. Despite aggressive antibiotic treatment, fluid hydration, and use of inotropes and extracorporeal membrane oxygenation, the patient succumbed to the disease. Early diagnosis of the potentially fatal disease followed by a prompt antibiotic regimen and appropriate use of steroids are cornerstones in the management of this disease to reduce the risk of high morbidity and mortality.

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Objectives/Hypothesis: Evaluation of the clinical outcomes after 6 months of treatment with a novel adjustable implant, the APrevent ® Vocal-Implant-System (VOIS), in conjunction with medialization thyroplasty (MT) in patients with unilateral vocal fold paralysis.Study Design: Prospective case series study at single tertiary referral center.Methods: Preoperative and 1 week, 7 weeks, and 6 months postoperative glottal efficiency (maximum phonation time [MPT]), voice quality (including GRBAS-scores and acoustic parameters) and self-perceived voice-related handicap (voice handicap index [VHI-30]) were measured and analyzed, whereas type of vocal fold closure was evaluated and determined by flexible videolaryngoscopy based on Södersten and Lindestad classification (Wilcoxon signed-rank test).Results: Thirteen patients underwent MT with VOIS under local anesthesia. Six months after surgery, the VHI-30 and MPT had improved from a preoperative mean of 75.0 AE 22.9 and 2.7 AE 2.1 s to a postoperative mean of 20.6 AE 19.7 and 6.3 AE 4.0 s, respectively. The mean GRBAS score improved from preoperative scores of G preop = 2.7, R preop = 2.6, B preop = 2.6, A preop = 2.2, and S preop = 2.0 to G postop = 0.3, R postop = 0.3, B postop = 0.2, A postop = 0.2, and S postop = 0.3 at 6 months postoperatively. Improved glottal closure was achieved in all patients (n = 13). Five patients received postoperative adjustment for the optimization of voice quality and glottal closure. No intra-or postoperative complications were observed. Significant improvements in acoustic parameters, including percentage jitter, percentage shimmer, and signal-to-noise ratio, were also observed after MT. All results were statistically significant (P < .05, Cohen's d > .8).Conclusions: APrevent ® VOIS-Implantation is a safe procedure with good voice outcomes. Postoperative adjustments can be performed smoothly to optimize voice quality and glottal closure.