Gina Vess - Academia.edu (original) (raw)

Papers by Gina Vess

Computers in Biology and Medicine, Feb 1, 2015

Background: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD)... more Background: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD) have not been well described. Very little is known about how inspiratory airflow is impacted when the vocal cords transition from normal inhalation state to a paradoxical adducted state; and how much change in laryngeal airflow and resistance occur before symptoms of stridor and air hunger emerge. This study provides new insight on the effects of VCD on respiratory airflow using computational fluid dynamics (CFD) techniques. Methods: Computed tomography images of a subject with normal vocal cords opening at the time of scanning were digitally modified to mimic an episode of VCD. To quantify and compare changes in inspiratory flow during VCD attack and normal inhalation, steady-state, laminar simulations were performed for three different breathing rates. Results: Pressure-flow analysis during VCD revealed that increasing inspiratory effort is not as efficient as in normal inhalation. Airflow resistance at the epiglottis was higher in the normal state (0.04 Pa.s/mL versus 0.02 Pa.s/mL) than in VCD; while resistance at the glottis and trachea remained roughly the same (0.04 Pa.s/mL) during normal inhalation, it escalated during VCD (0.11 Pa.s/mL and 0.13 Pa.s/mL at the glottis and trachea, respectively). Peak airflow velocity and vorticity occurred around the glottis during VCD, and at the epiglottis during normal inhalation. Conclusions: This pilot study demonstrates that attempting to force more inspired air will yield greater glottal resistance during VCD. Furthermore, there were evidence of abrupt laryngeal pressure gradient, chaotic airflow and high concentration of shear stresses in the glottal region.

Otolaryngology-Head and Neck Surgery, Apr 4, 2014

A Case of Dysphonia and Cough Caused by Spontaneous Intracranial Hypotension Otolaryngology– Head... more A Case of Dysphonia and Cough Caused by Spontaneous Intracranial Hypotension Otolaryngology– Head and Neck Surgery 2014, Vol. 151(2) 367–368 American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0194599814529913 http://otojournal.org Mirabelle Sajisevi, MD, Gina Vess, MA, CCC-SLP, and David L. Witsell, MD, MHS

The Journal of Heart and Lung Transplantation, 2007

Background: Gastroesophageal reflux is associated with lung transplantation (LT) and bronchioliti... more Background: Gastroesophageal reflux is associated with lung transplantation (LT) and bronchiolitis obliterans syndrome, limiting allograft functional longevity. LT patients may also develop post-operative oropharyngeal dysphagia, exposing the allograft to further risk. However, the magnitude of this problem is unknown. We examined LT recipients post-operatively for swallowing disorders and correlated findings with pre-and post-operative variables. Methods: Two hundred sixty-three LT patients (January 2001 to July 2005) at a single center were retrospectively reviewed. Each underwent clinical swallowing assessment. Provocative swallowing evaluation (SE) was performed in 149 patients (Group 1); 114 patients did not receive formal SE (Group 2). SE studies were considered positive with laryngeal penetration (PEN) or tracheal aspiration (ASP) of thin liquids. Groups were compared with respect to pre-, peri-and post-operative variables using analysis of variance (ANOVA) and chi-square tests. Results: After LT, 56.7% of patients underwent post-operative SE (mean 19 Ϯ 20 days), most of whom (87.9%) had fiber-optic endoscopic studies. SE was positive for PEN or ASP in 70.5% (n ϭ 105). Aspiration occurred in 63.8% (n ϭ 67) of positive SEs; 77.6% (n ϭ 52) of ASP assessments were clinically silent. Pre-operative gastroesophageal reflux disease (GERD) and post-operative complications, including vocal cord paresis, pleural processes, venous thromboses and severe rejection episodes, were more common among Group 1. Group 2 had a significantly reduced hospital length of stay (p ϭ 0.004). Conclusions: Prospective SE identified strikingly high rates of dysphagia after LT. Because many of these deficits are silent, aggressive pulmonary toilet is especially important after post-operative LT. Pre-operative SE may clarify those at increased risk for new-onset oropharyngeal dysphagia after LT.

The Journal of Heart and Lung Transplantation, 2007

Background: Gastroesophageal reflux is associated with lung transplantation (LT) and bronchioliti... more Background: Gastroesophageal reflux is associated with lung transplantation (LT) and bronchiolitis obliterans syndrome, limiting allograft functional longevity. LT patients may also develop post-operative oropharyngeal dysphagia, exposing the allograft to further risk. However, the magnitude of this problem is unknown. We examined LT recipients post-operatively for swallowing disorders and correlated findings with pre-and post-operative variables. Methods: Two hundred sixty-three LT patients (January 2001 to July 2005) at a single center were retrospectively reviewed. Each underwent clinical swallowing assessment. Provocative swallowing evaluation (SE) was performed in 149 patients (Group 1); 114 patients did not receive formal SE (Group 2). SE studies were considered positive with laryngeal penetration (PEN) or tracheal aspiration (ASP) of thin liquids. Groups were compared with respect to pre-, peri-and post-operative variables using analysis of variance (ANOVA) and chi-square tests. Results: After LT, 56.7% of patients underwent post-operative SE (mean 19 Ϯ 20 days), most of whom (87.9%) had fiber-optic endoscopic studies. SE was positive for PEN or ASP in 70.5% (n ϭ 105). Aspiration occurred in 63.8% (n ϭ 67) of positive SEs; 77.6% (n ϭ 52) of ASP assessments were clinically silent. Pre-operative gastroesophageal reflux disease (GERD) and post-operative complications, including vocal cord paresis, pleural processes, venous thromboses and severe rejection episodes, were more common among Group 1. Group 2 had a significantly reduced hospital length of stay (p ϭ 0.004). Conclusions: Prospective SE identified strikingly high rates of dysphagia after LT. Because many of these deficits are silent, aggressive pulmonary toilet is especially important after post-operative LT. Pre-operative SE may clarify those at increased risk for new-onset oropharyngeal dysphagia after LT.

The Journal of Heart and Lung Transplantation, 2007

Otolaryngology -- Head and Neck Surgery, 2014

Computers in Biology and Medicine, 2015

Background: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD)... more Background: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD) have not been well described. Very little is known about how inspiratory airflow is impacted when the vocal cords transition from normal inhalation state to a paradoxical adducted state; and how much change in laryngeal airflow and resistance occur before symptoms of stridor and air hunger emerge. This study provides new insight on the effects of VCD on respiratory airflow using computational fluid dynamics (CFD) techniques. Methods: Computed tomography images of a subject with normal vocal cords opening at the time of scanning were digitally modified to mimic an episode of VCD. To quantify and compare changes in inspiratory flow during VCD attack and normal inhalation, steady-state, laminar simulations were performed for three different breathing rates. Results: Pressure-flow analysis during VCD revealed that increasing inspiratory effort is not as efficient as in normal inhalation. Airflow resistance at the epiglottis was higher in the normal state (0.04 Pa.s/mL versus 0.02 Pa.s/mL) than in VCD; while resistance at the glottis and trachea remained roughly the same (0.04 Pa.s/mL) during normal inhalation, it escalated during VCD (0.11 Pa.s/mL and 0.13 Pa.s/mL at the glottis and trachea, respectively). Peak airflow velocity and vorticity occurred around the glottis during VCD, and at the epiglottis during normal inhalation. Conclusions: This pilot study demonstrates that attempting to force more inspired air will yield greater glottal resistance during VCD. Furthermore, there were evidence of abrupt laryngeal pressure gradient, chaotic airflow and high concentration of shear stresses in the glottal region.

The Laryngoscope, 2008

The user has requested enhancement of the downloaded file. All in-text references underlined in b... more The user has requested enhancement of the downloaded file. All in-text references underlined in blue are added to the original document and are linked to publications on ResearchGate, letting you access and read them immediately.

Computers in Biology and Medicine, 2015

Background: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD)... more Background: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD) have not been well described. Very little is known about how inspiratory airflow is impacted when the vocal cords transition from normal inhalation state to a paradoxical adducted state; and how much change in laryngeal airflow and resistance occur before symptoms of stridor and air hunger emerge. This study provides new insight on the effects of VCD on respiratory airflow using computational fluid dynamics (CFD) techniques. Methods: Computed tomography images of a subject with normal vocal cords opening at the time of scanning were digitally modified to mimic an episode of VCD. To quantify and compare changes in inspiratory flow during VCD attack and normal inhalation, steady-state, laminar simulations were performed for three different breathing rates. Results: Pressure-flow analysis during VCD revealed that increasing inspiratory effort is not as efficient as in normal inhalation. Airflow resistance at the epiglottis was higher in the normal state (0.04 Pa.s/mL versus 0.02 Pa.s/mL) than in VCD; while resistance at the glottis and trachea remained roughly the same (0.04 Pa.s/mL) during normal inhalation, it escalated during VCD (0.11 Pa.s/mL and 0.13 Pa.s/mL at the glottis and trachea, respectively). Peak airflow velocity and vorticity occurred around the glottis during VCD, and at the epiglottis during normal inhalation. Conclusions: This pilot study demonstrates that attempting to force more inspired air will yield greater glottal resistance during VCD. Furthermore, there were evidence of abrupt laryngeal pressure gradient, chaotic airflow and high concentration of shear stresses in the glottal region.

The Laryngoscope, 2008

Objectives/Hypothesis: Videolaryngostroboscopy (VLS) is considered an important diagnostic tool i... more Objectives/Hypothesis: Videolaryngostroboscopy (VLS) is considered an important diagnostic tool in the evaluation of patients with laryngeal/voice disorders. We evaluated the frequency of, diagnoses associated with, and factors related to VLS use in the evaluation of outpatients with laryngeal/voice disorders.

Otolaryngology -- Head and Neck Surgery, 2014

The Journal of Heart and Lung Transplantation, 2007

The Journal of Heart and Lung Transplantation, 2007

Background: Gastroesophageal reflux is associated with lung transplantation (LT) and bronchioliti... more Background: Gastroesophageal reflux is associated with lung transplantation (LT) and bronchiolitis obliterans syndrome, limiting allograft functional longevity. LT patients may also develop post-operative oropharyngeal dysphagia, exposing the allograft to further risk. However, the magnitude of this problem is unknown. We examined LT recipients post-operatively for swallowing disorders and correlated findings with pre-and post-operative variables.

Computers in Biology and Medicine, Feb 1, 2015

Background: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD)... more Background: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD) have not been well described. Very little is known about how inspiratory airflow is impacted when the vocal cords transition from normal inhalation state to a paradoxical adducted state; and how much change in laryngeal airflow and resistance occur before symptoms of stridor and air hunger emerge. This study provides new insight on the effects of VCD on respiratory airflow using computational fluid dynamics (CFD) techniques. Methods: Computed tomography images of a subject with normal vocal cords opening at the time of scanning were digitally modified to mimic an episode of VCD. To quantify and compare changes in inspiratory flow during VCD attack and normal inhalation, steady-state, laminar simulations were performed for three different breathing rates. Results: Pressure-flow analysis during VCD revealed that increasing inspiratory effort is not as efficient as in normal inhalation. Airflow resistance at the epiglottis was higher in the normal state (0.04 Pa.s/mL versus 0.02 Pa.s/mL) than in VCD; while resistance at the glottis and trachea remained roughly the same (0.04 Pa.s/mL) during normal inhalation, it escalated during VCD (0.11 Pa.s/mL and 0.13 Pa.s/mL at the glottis and trachea, respectively). Peak airflow velocity and vorticity occurred around the glottis during VCD, and at the epiglottis during normal inhalation. Conclusions: This pilot study demonstrates that attempting to force more inspired air will yield greater glottal resistance during VCD. Furthermore, there were evidence of abrupt laryngeal pressure gradient, chaotic airflow and high concentration of shear stresses in the glottal region.

Otolaryngology-Head and Neck Surgery, Apr 4, 2014

A Case of Dysphonia and Cough Caused by Spontaneous Intracranial Hypotension Otolaryngology– Head... more A Case of Dysphonia and Cough Caused by Spontaneous Intracranial Hypotension Otolaryngology– Head and Neck Surgery 2014, Vol. 151(2) 367–368 American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0194599814529913 http://otojournal.org Mirabelle Sajisevi, MD, Gina Vess, MA, CCC-SLP, and David L. Witsell, MD, MHS

The Journal of Heart and Lung Transplantation, 2007

Background: Gastroesophageal reflux is associated with lung transplantation (LT) and bronchioliti... more Background: Gastroesophageal reflux is associated with lung transplantation (LT) and bronchiolitis obliterans syndrome, limiting allograft functional longevity. LT patients may also develop post-operative oropharyngeal dysphagia, exposing the allograft to further risk. However, the magnitude of this problem is unknown. We examined LT recipients post-operatively for swallowing disorders and correlated findings with pre-and post-operative variables. Methods: Two hundred sixty-three LT patients (January 2001 to July 2005) at a single center were retrospectively reviewed. Each underwent clinical swallowing assessment. Provocative swallowing evaluation (SE) was performed in 149 patients (Group 1); 114 patients did not receive formal SE (Group 2). SE studies were considered positive with laryngeal penetration (PEN) or tracheal aspiration (ASP) of thin liquids. Groups were compared with respect to pre-, peri-and post-operative variables using analysis of variance (ANOVA) and chi-square tests. Results: After LT, 56.7% of patients underwent post-operative SE (mean 19 Ϯ 20 days), most of whom (87.9%) had fiber-optic endoscopic studies. SE was positive for PEN or ASP in 70.5% (n ϭ 105). Aspiration occurred in 63.8% (n ϭ 67) of positive SEs; 77.6% (n ϭ 52) of ASP assessments were clinically silent. Pre-operative gastroesophageal reflux disease (GERD) and post-operative complications, including vocal cord paresis, pleural processes, venous thromboses and severe rejection episodes, were more common among Group 1. Group 2 had a significantly reduced hospital length of stay (p ϭ 0.004). Conclusions: Prospective SE identified strikingly high rates of dysphagia after LT. Because many of these deficits are silent, aggressive pulmonary toilet is especially important after post-operative LT. Pre-operative SE may clarify those at increased risk for new-onset oropharyngeal dysphagia after LT.

The Journal of Heart and Lung Transplantation, 2007

Background: Gastroesophageal reflux is associated with lung transplantation (LT) and bronchioliti... more Background: Gastroesophageal reflux is associated with lung transplantation (LT) and bronchiolitis obliterans syndrome, limiting allograft functional longevity. LT patients may also develop post-operative oropharyngeal dysphagia, exposing the allograft to further risk. However, the magnitude of this problem is unknown. We examined LT recipients post-operatively for swallowing disorders and correlated findings with pre-and post-operative variables. Methods: Two hundred sixty-three LT patients (January 2001 to July 2005) at a single center were retrospectively reviewed. Each underwent clinical swallowing assessment. Provocative swallowing evaluation (SE) was performed in 149 patients (Group 1); 114 patients did not receive formal SE (Group 2). SE studies were considered positive with laryngeal penetration (PEN) or tracheal aspiration (ASP) of thin liquids. Groups were compared with respect to pre-, peri-and post-operative variables using analysis of variance (ANOVA) and chi-square tests. Results: After LT, 56.7% of patients underwent post-operative SE (mean 19 Ϯ 20 days), most of whom (87.9%) had fiber-optic endoscopic studies. SE was positive for PEN or ASP in 70.5% (n ϭ 105). Aspiration occurred in 63.8% (n ϭ 67) of positive SEs; 77.6% (n ϭ 52) of ASP assessments were clinically silent. Pre-operative gastroesophageal reflux disease (GERD) and post-operative complications, including vocal cord paresis, pleural processes, venous thromboses and severe rejection episodes, were more common among Group 1. Group 2 had a significantly reduced hospital length of stay (p ϭ 0.004). Conclusions: Prospective SE identified strikingly high rates of dysphagia after LT. Because many of these deficits are silent, aggressive pulmonary toilet is especially important after post-operative LT. Pre-operative SE may clarify those at increased risk for new-onset oropharyngeal dysphagia after LT.

The Journal of Heart and Lung Transplantation, 2007

Otolaryngology -- Head and Neck Surgery, 2014

Computers in Biology and Medicine, 2015

Background: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD)... more Background: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD) have not been well described. Very little is known about how inspiratory airflow is impacted when the vocal cords transition from normal inhalation state to a paradoxical adducted state; and how much change in laryngeal airflow and resistance occur before symptoms of stridor and air hunger emerge. This study provides new insight on the effects of VCD on respiratory airflow using computational fluid dynamics (CFD) techniques. Methods: Computed tomography images of a subject with normal vocal cords opening at the time of scanning were digitally modified to mimic an episode of VCD. To quantify and compare changes in inspiratory flow during VCD attack and normal inhalation, steady-state, laminar simulations were performed for three different breathing rates. Results: Pressure-flow analysis during VCD revealed that increasing inspiratory effort is not as efficient as in normal inhalation. Airflow resistance at the epiglottis was higher in the normal state (0.04 Pa.s/mL versus 0.02 Pa.s/mL) than in VCD; while resistance at the glottis and trachea remained roughly the same (0.04 Pa.s/mL) during normal inhalation, it escalated during VCD (0.11 Pa.s/mL and 0.13 Pa.s/mL at the glottis and trachea, respectively). Peak airflow velocity and vorticity occurred around the glottis during VCD, and at the epiglottis during normal inhalation. Conclusions: This pilot study demonstrates that attempting to force more inspired air will yield greater glottal resistance during VCD. Furthermore, there were evidence of abrupt laryngeal pressure gradient, chaotic airflow and high concentration of shear stresses in the glottal region.

The Laryngoscope, 2008

The user has requested enhancement of the downloaded file. All in-text references underlined in b... more The user has requested enhancement of the downloaded file. All in-text references underlined in blue are added to the original document and are linked to publications on ResearchGate, letting you access and read them immediately.

Computers in Biology and Medicine, 2015

Background: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD)... more Background: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD) have not been well described. Very little is known about how inspiratory airflow is impacted when the vocal cords transition from normal inhalation state to a paradoxical adducted state; and how much change in laryngeal airflow and resistance occur before symptoms of stridor and air hunger emerge. This study provides new insight on the effects of VCD on respiratory airflow using computational fluid dynamics (CFD) techniques. Methods: Computed tomography images of a subject with normal vocal cords opening at the time of scanning were digitally modified to mimic an episode of VCD. To quantify and compare changes in inspiratory flow during VCD attack and normal inhalation, steady-state, laminar simulations were performed for three different breathing rates. Results: Pressure-flow analysis during VCD revealed that increasing inspiratory effort is not as efficient as in normal inhalation. Airflow resistance at the epiglottis was higher in the normal state (0.04 Pa.s/mL versus 0.02 Pa.s/mL) than in VCD; while resistance at the glottis and trachea remained roughly the same (0.04 Pa.s/mL) during normal inhalation, it escalated during VCD (0.11 Pa.s/mL and 0.13 Pa.s/mL at the glottis and trachea, respectively). Peak airflow velocity and vorticity occurred around the glottis during VCD, and at the epiglottis during normal inhalation. Conclusions: This pilot study demonstrates that attempting to force more inspired air will yield greater glottal resistance during VCD. Furthermore, there were evidence of abrupt laryngeal pressure gradient, chaotic airflow and high concentration of shear stresses in the glottal region.

The Laryngoscope, 2008

Objectives/Hypothesis: Videolaryngostroboscopy (VLS) is considered an important diagnostic tool i... more Objectives/Hypothesis: Videolaryngostroboscopy (VLS) is considered an important diagnostic tool in the evaluation of patients with laryngeal/voice disorders. We evaluated the frequency of, diagnoses associated with, and factors related to VLS use in the evaluation of outpatients with laryngeal/voice disorders.

Otolaryngology -- Head and Neck Surgery, 2014

The Journal of Heart and Lung Transplantation, 2007

The Journal of Heart and Lung Transplantation, 2007

Background: Gastroesophageal reflux is associated with lung transplantation (LT) and bronchioliti... more Background: Gastroesophageal reflux is associated with lung transplantation (LT) and bronchiolitis obliterans syndrome, limiting allograft functional longevity. LT patients may also develop post-operative oropharyngeal dysphagia, exposing the allograft to further risk. However, the magnitude of this problem is unknown. We examined LT recipients post-operatively for swallowing disorders and correlated findings with pre-and post-operative variables.