Fold Motion Research Articles

Assessment of vocal fold movement through anterior-posterior view of videofluoroscopic swallowing study.

The aim of this study is to assess the value of using videofluoroscopic swallowing study (VFSS) for assessing vocal fold paralysis. This was a retrospective study of patients who underwent VFSS with a vocal fold testing maneuver from June 2020 to February 2022, and who had undergone laryngoscopy within 2 weeks before or after VFSS. The vocal fold testing maneuver consisted of making an 'e' sound for about 2-3 seconds during VFSS anterior-posterior (AP) view. The diagnostic value of the VFSS was evaluated by a trained reviewer, who assessed the presence and laterality of vocal fold paralysis by examining videos of the patients performing the vocal fold testing maneuver. Intra-rater reliability was determined by evaluation of the videos by the same reviewer 2 weeks later, and inter-rater reliability was determined by evaluation by a second reviewer. Seventy patients were enrolled in the study. The positive predictive value was 91.43% and the intra-rater and inter-rater reliabilities, as determined by Cohen's kappa value, were 0.746 and 0.824 respectively. The presence and laterality of vocal fold paralysis were identified accurately and reliably by the reviewers, showing that VFSS can be used to assess vocal fold paralysis. 2.

Analysis of dynamic process of thick-panel origami structures based on finite particle method

Origami structures are widely used in engineering fields, but the thickness of origami structures cannot be ignored in practical engineering. The folding and unfolding motions of thick-panel origami structures involve the coupling of structural deformation and rigid-body motion, and the contact constraints between thick panels are complex. In this study, a novel method for the dynamic process of thick-panel origami structures is proposed based on the finite particle method (FPM). Firstly, the fine modeling and simplified modeling of thick-panel origami structures are presented. Specifically, the fine modeling adopts a particle-solid model while the simplified modeling uses a particle-bar-spring model. Subsequently, hexahedral element and bar element adopted to model thick panels are briefly introduced. Bar-to-bar spring element is developed to maintain the shapes of thick panels in the particle-bar-spring model. Surface-to-surface spring element is improved to provide the driving forces at creases. Surface-to-surface contact element is also derived to consider the contact constraints between thick panels. Validations including two quantitative validations with experiments are conducted to verify the effectiveness of the proposed method. The dynamic processes of two typical thick-panel origami structures, i.e., the symmetric four-crease circular thick-panel origami structure and the compact-folding thick-panel origami structure, are modeled and analyzed, and the influence of panel stiffness on the dynamic process of the latter thick-panel origami structure is discussed in depth. The corresponding physical prototypes are also manufactured to provide qualitative validations of the proposed numerical framework.

Ultrasound Screening After Cardiac Surgery Shows Vocal Fold Impairment and Predicts Aspiration.

Vocal fold motion impairment (VFMI) is a known consequence after high-risk cardiac surgery. We implemented a universal laryngeal ultrasound (LUS) screening protocol for VFMI after the Norwood and aortic arch surgery. We hypothesized that LUS would accurately identify VFMI and predict postoperative aspiration. We implemented a screening algorithm with LUS for patients undergoing high-risk cardiac surgery at a tertiary care pediatric hospital. Positively screened patients underwent flexible nasolaryngoscopy (FNL). Patients with an abnormal FNL underwent a video-fluoroscopic swallow study (VFSS). Patient demographics, length of stay, and swallowing outcomes were assessed. Two-tailed chi square and Wilcoxon rank sum tests were used to assess for differences. Sixty-seven patients underwent either Norwood or arch reconstruction over a 16-month period and underwent universal LUS. The average birth weight was 3.24 kg (SD 0.57). Of the 67 patients, VFMI was identified by LUS and 100% confirmed on FNL in 58.21% (n = 39/67) of patients. Aspiration and penetration on VFSS were higher in the group with VFMI as compared with those without VFMI (53.8% vs. 21.4%, p = 0.008). There was no difference in length of stay between patients who did not have a diagnosis of VFMI and those found to have VFMI (41.0 days vs 45.3 days p = 0.73). Universal LUS screening for patients following high-risk cardiac surgery may lead to earlier identification of postoperative VFMI and aspiration. Recognition of VFMI through this universal screening program could lead to earlier interventions and possibly improved swallowing outcomes. 3 Laryngoscope, 134:1939-1944, 2024.

Nonlinear wrap-folding of membranes with predefined creases and seams

The investigation of folding processes of aerospace membrane structures holds significant importance due to the limited volume of launch vehicles. This paper presents a simulation system for membrane wrap-folding with predefined creases and seams. To transform non-rigid foldable configurations into rigid foldable ones, the methods of adding creases and cutting strategies are introduced. The formulation of constraint equations for the hinged rod system model enables the analysis of the rigid folding motion. A two-stage folding strategy is also implemented for fully folding, consisting of an initial rigid folding stage followed by an additional displacement folding stage. By incorporating the crease strategy and employing a two-stage driving mode, the stress levels throughout the folding process are minimized. Furthermore, accounts for the presence of seam areas, placing the seam at the crease creates wrinkles smaller when folded. The findings contribute to a deeper understanding of membrane folding behavior, leading to advancements in their design and application.

Characteristics of post-stroke dysphagia: A retrospective study based on FEES.

This study aims to examine the characteristics of dysphagia in stroke patients with different lesion sites and explore the factors that impact the duration of nasogastric tube after post-stroke dysphagia (PSD). Patients with PSD were screened for analysis. Stroke types and lesion sites were confirmed using MRI or CT scans. Included patients were categorized into two groups: supratentorial stroke group (including lobar and deep intracerebral stroke subgroups) and infratentorial stroke group (including brainstem and cerebellar stroke subgroups). Fiberoptic endoscopic evaluation of swallowing (FEES), Penetration-aspiration scale (PAS), Yale pharyngeal residue (PR) severity rating scale, Functional oral intake scale (FOIS), Murray secretion severity rating scale (MSS), laryngopharyngeal sensation, and vocal fold mobility were investigated to assess the swallowing function. A total of 94 patients were included in the final analysis. Significant differences were found in PR scores (p<.001), PAS scores (p<.05), MSS scores (p<.05), and vocal fold mobility (p<.001) between infratentorial and supratentorial stroke groups. Moreover, lobar stroke showed significantly higher PR scores compared to the deep intracerebral stroke group (p<.05). Kaplan-Meier survival analysis indicated significant differences in the duration of nasogastric tube placement among the following groups: infratentorial versus supratentorial stroke, PAS ≤ 5versus PAS>5, PR ≥ 3versus PR<3, and normal vocal fold mobility versus vocal fold motion impairment group (p<.05). The infratentorial stroke may lead to worse swallowing function as compared to a supratentorial stroke. Additionally, patients with infratentorial stroke, PAS>5, PR ≥ 3, or vocal fold motion impairment may contribute to a longer duration of nasogastric tube placement.

A Spider-Joint-like Bionic Actuator with an Approximately Triangular Prism Shape.

The unique drive principle and strong manipulation ability of spider legs have led to several bionic robot designs. However, some parameters of bionic actuators still need to be improved, such as torque. Inspired by the hydraulic drive principle of spider legs, this paper describes the design of a bionic actuator characterized by the use of air pressure on each surface and its transmittance in the direction of movement, achieving a torque amplification effect. The produced torque is as high as 4.78 N m. In addition, its torque characteristics during folding motions are similar to those during unfolding motions, showing that the bionic actuator has stable bidirectional drive capability.

Patient tolerance in office-based blue laser therapy for lesions of the vocal folds: Correlation with patients' characteristics, disease type and procedure-related factors.

To report patient tolerance in office-based blue laser therapy for vocal fold lesions. A retrospective review of the medical records of patients who underwent office-based blue laser therapy for lesions of the vocal folds between November 2021 and February 2023 was conducted. A total of 48 patients were included. Patient tolerance was assessed using the Iowa Satisfaction with Anesthesia Scale (IOWA). Patient tolerance was analyzed in relation to patients' demographic characteristics, disease type and severity, and procedure-related factors. The mean tolerance score of the study group was 1.51 ± 1.1. There was a significant difference in the mean tolerance score between smokers and non-smokers (p = .038). Patients with vocal fold cyst (n = 3) had the highest mean tolerance score followed by patients with vocal fold polyps (n = 15). There was a nonsignificant difference in the mean tolerance score between benign lesions of the vocal folds and leukoplakia. Patients with lesions extending to more than half the vocal fold had less tolerance than those with lesions limited to less than half the vocal fold (1.91 vs. 1.27, p value .041). There was a moderate and significant negative correlation between vocal fold movement VAS, swallowing VAS, and tolerance score. The mean total duration of the procedures was 10.38 ± 4.8 min. There was a mild negative correlation between the duration of the procedure and tolerance. Office-based blue laser therapy for vocal fold lesions is a well-tolerated procedure. Patient should be instructed how to breathe quietly and avoid swallows to improve tolerance to surgery. 4.

Novel open-section origami tubes with multiple programmable mechanical properties

The diverse folding motion of the origami structures induces a series of extraordinary properties, which enriches their application prospects in engineering. In this paper, we propose a class of open-section origami tubes with multiple extraordinary mechanical properties, and explore their potential applications. First, three types of origami tubes with one degree of freedom are developed. Their motion patterns are studied through the kinematic analysis, which induces several extraordinary mechanical properties. The Poisson’s ratio of the proposed structure undergoes multiple sign-flipping, which can be tuned by the geometric parameters of panels. Also, the origami tubes exhibit multiple mechanical properties under compression such as mono/bistable and zero stiffness mode, which can be tuned by the rotational stiffness assignment of the creases. The self-locking behavior of the tandem origami tubes is also discussed, which shows the remarkable programmability on the number and position of locking. Based on the proposed origami cells, the piecewise-stiffness structure and quasi-zero-stiffness structure are constructed, and their performance is verified through the prototype tests.

Tristable property and the high stiffness analysis of Kresling pattern origami

Kresling pattern origami is known for its bistable property, as confirmed by the truss model used to analyze its dynamics. However, our theoretical research and folding experiments reveal that the Kresling pattern origami possesses three stable states during folding motion, with the third state exhibiting high stiffness. These represent exciting new achievements for origami research. Here, Kresling pattern origami is studied using the geometric definitions of triangulated cylindrical origami and triangulated conical origami, and the truss model is corrected based on the proposed tristable property and an established mathematical model of the third stable state. Analysis of the energy landscapes obtained from the corrected truss model reveals various properties of the Kresling pattern origami that confirm its tristable property. In addition, origami-inspired structures are created that exhibit excellent deployability, collapsibility, load-bearing capacity, and multistability. Thereafter, the high stiffness of the third stable state is validated experimentally. These studies can provide new content for constructing multistable metamaterials and improving the load-bearing capacity of deployable structures.

High-Speed and High-Resolution 3D Printing of Self-Healing and Ion-Conductive Hydrogels via μCLIP

Conductive and self-healing (SH) hydrogels have been receiving continuous attention, which could broaden the design of ionotronic devices for health monitoring systems and soft robots with the ability to repair damage autonomously. So far, three-dimensional (3D) fabrication of such SH hydrogels is mainly limited to traditional molding/casting or extrusion-based 3D printing methods, which limits the formation of sophisticated structures with high-resolution features. Furthermore, the need of external stimuli (e.g., water, heat, and pH change) to achieve SH behavior could restrict their wide application. Herein, we report an ion-conductive SH hydrogel suitable for a home-built high-resolution and high-speed 3D printing process, micro continuous liquid interface production (μCLIP). This material system relies on interpenetrating polymer networks (IPN) hydrogel formed by physically cross-linked poly(vinyl alcohol) combined with chemically/ionically cross-linked poly(acrylic acid) and ferric chloride. By carefully optimizing the resin’s composition, we can balance high-resolution printability and superb SH capability, at the same time manifesting sufficient ion conductivity. Specifically, complex 3D structures with microscale features (down to 100 μm) can be printed at speeds up to 16.5 μm s–1. Upon damage occurs, hydrogen bonds within hydroxyl and carboxyl groups, as well as ionic bonds generated from ferric ions, contribute together to achieve fast and high efficiency SH, which can restore 90% (100%) of the original mechanical strength at room temperature within 4 h (8 h) without any external stimulus. In addition, both the as-printed and self-healed hydrogels manifest superior ion conductivity and stretchability. Therefore, the SH hydrogels can be rapidly printed and tailored as customized wearable sensors, and the sensing capabilities were quantitatively investigated and compared. In terms of applications, SH hydrogel-based knuckle sensors were prototyped to detect a finger’s folding and unfolding motions.

Multi-triangles cylindrical origami and inspired metamaterials with tunable stiffness and stretchable robotic arm.

Kresling pattern origami-inspired structural design has been widely investigated using its bistable property and the single coupling degree of freedom (DOF). In order to obtain new properties or new origami-inspired structures, it needs to innovate the crease lines in the flat sheet of Kresling pattern origami. Here, we present a derivative of Kresling pattern origami-multi-triangles cylindrical origami (MTCO) with tristable property. The truss model is modified based on the switchable active crease lines during the folding motion of the MTCO. Using the energy landscape obtained from the modified truss model, the tristable property is validated and extended to Kresling pattern origami. Simultaneously, the high stiffness property of the third stable state and some special stable states are discussed. In addition, MTCO-inspired metamaterials with deployable property and tunable stiffness, and MTCO-inspired robotic arms with wide movement ranges and rich motion forms are created. These works promote research on Kresling pattern origami, and the design ideas of the metamaterials and robotic arms play a positive role in improving the stiffness of deployable structures and conceiving motion robots.

Screening for Vocal Fold Movement Impairment in Children Undergoing Esophageal and Airway Surgery.

Children undergoing cervical and/or thoracic operations are at risk for recurrent laryngeal nerve injury, resulting in vocal fold movement impairment (VFMI). Screening for VFMI is often reserved for symptomatic patients. Identify the prevalence of VFMI in screened preoperative patients prior to an at-risk operation to evaluate the value of screening all patients at-risk for VFMI, regardless of symptoms. A single center, retrospective review of all patients undergoing a preoperative flexible nasolaryngoscopy between 2017 and 2021, examining the presence of VFMI and associated symptoms. We evaluated 297 patients with a median (IQR) age of 18 (7.8, 56.3) months and a weight of 11.3 (7.8, 17.7) kilograms. Most had a history of esophageal atresia (EA, 60%), and a prior at-risk cervical or thoracic operation (73%). Overall, 72 (24%) patients presented with VFMI (51% left, 26% right, and 22% bilateral). Of patients with VFMI, 47% did not exhibit the classic symptoms (stridor, dysphonia, and aspiration) of VFMI. Dysphonia was the most prevalent classic VFMI symptom, yet only present in 18 (25%) patients. Patients presenting with a history of at-risk surgery (OR 2.3, 95%CI 1.1, 4.8, p= 0.03), presence of a tracheostomy (OR 3.1, 95%CI 1.0, 10.0, p= 0.04), or presence of a surgical feeding tube (OR 3.1, 95%CI 1.6, 6.2, p= 0.001) were more likely to present with VFMI. Routine screening for VFMI should be considered in all at-risk patients, regardless of symptoms or prior operations, particularly in those with a history of an at-risk surgery, presence of tracheostomy, or a surgical feeding tube. 3 Laryngoscope, 133:3564-3570, 2023.

Pediatric Dysphonia: When to Refer.

The reported prevalence of voice disorders in the pediatric population varies widely between studies, ranging from 3.9% to 23%. Despite this, not all children with dysphonia are referred to a voice specialist for further evaluation. The objective of this study is to examine the relationship between dysphonia history, voice assessment, and laryngeal findings to help guide referrals of dysphonic children. A retrospective review was conducted of pediatric patients at a tertiary voice clinic between January 2014 and December 2017. Data including dates of presentation, demographics, co-morbidities, presenting symptoms, laryngeal exam findings, Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) scores, and Pediatric Voice Handicap Index (pVHI) scores were collected and analyzed. Of 475 patients initially identified, 459 met inclusion criteria and were reviewed. In all, 272 (59.3%) were male and 187 (40.7%) were female. Mean age at first presentation was 8.6 years old (range: 2-18). Males were more likely to present at a younger age than females. CAPE-V data were available for 439 patients, and pVHI data were available for 109 patients. The mean CAPE-V Overall Severity score was 38.2. The mean total pVHI score was 25.4. Males had higher CAPE-V Overall Severity (40.0 vs. 35.4), Roughness (32.2 vs. 27.6), and Strain scores (37.2 vs. 32.4) than females. Patient pVHI scores did not differ by gender. In all, 283 patients self-reported a length of symptoms prior to evaluation. Children with a longer duration of symptoms prior to evaluation had higher CAPE-V Overall Severity scores. Diagnoses of vocal fold movement impairment and benign vocal fold lesions that were not nodules were associated with higher average CAPE-V Overall Severity scores. Overall, 310 patients (67.5%) were recommended intervention for their dysphonia. These patients had higher CAPE-V Overall Severity scores than those who were solely recommended observation (42.8 vs. 28.0). Males were more likely than females to present with dysphonia and presented with more severe perceptual dysphonia scores on average. The length of symptoms and certain diagnoses correlated with higher CAPE-V Scores. Referrals to a pediatric voice clinic should be considered in patients with a dysphonia history lasting greater than 3 months and in patients with more severe symptoms.

Behind the Complex Interplay of Phonation: Investigating Elasticity of Vocal Folds With Pipette Aspiration Technique During Ex Vivo Phonation Experiments

Objectives: The vibration of the vocal folds produces the primary sound for the human speech. The vibration depends mainly on the pressure, airflow of the lungs, and the material properties of the vocal folds. In order to change them, muscles in the larynx stretch the vocal folds. This interplay is rarely investigated, but can give insight in the complex process of speech production. Most material properties studies are damaging the tissue; therefore, a nondestructive one is desired. Methods: An ex vivo phonation experiment combined with the dynamic Pipette Aspiration Technique is used to investigate 10 porcine larynges, under manipulations of different adduction and elongation levels. For each manipulation, the near surface material properties of the vocal folds are measured as well as different phonation parameters like the subglottal pressure, glottal resistance, frequency, and stiffness. Thereby, a high-speed camera was used to record the vocal fold movement. Results: On most of the measured parameters, the manipulations do show an effect. Both manipulations lead to a higher phonation frequency and an increase of the stiffness of the tissue. Comparing both manipulations, the elongation results in higher elasticity values than the adduction. Different measurement parameters have been compared with each other and correlations could be found. Where the strongest correlation are found among the elasticity values of different frequencies. But it can also be seen that the elasticity values correlate with phonation parameters. Conclusion: It was possible to produce a data set of 560 measurements in total. To our knowledge, this is the first time Pipette Aspiration Technique was combined with ex vivo phonation measurements for combined measurements. The amount of measurement data made it possible to carry out statistic investigations. The effect of the manipulations on material properties as well as on phonation parameters could be measured and different correlations could be found. The results lead to the hypothesis that the stretch does not have a huge effect on the material properties of the lamina propria, but more on the underlying muscle.

A review of the peripheral proprioceptive apparatus in the larynx.

The larynx is an organ of the upper airway that participates in breathing, glutition, voice production, and airway protection. These complex functions depend on vocal fold (VF) movement, facilitated in turn by the action of the intrinsic laryngeal muscles (ILM). The necessary precise and near-instantaneous modulation of each ILM contraction relies on proprioceptive innervation of the larynx. Dysfunctional laryngeal proprioception likely contributes to disorders such as laryngeal dystonia, dysphagia, vocal fold paresis, and paralysis. While the proprioceptive system in skeletal muscle derived from somites is well described, the proprioceptive circuitry that governs head and neck structures such as VF has not been so well characterized. For over two centuries, researchers have investigated the question of whether canonical proprioceptive organs, muscle spindles, and Golgi tendon organs, exist in the ILM, with variable findings. The present work is a state-of-the-art review of the peripheral component of laryngeal proprioception, including current knowledge of canonical and possible alternative proprioceptive circuitry elements in the larynx.

Effects of Unilateral Vagotomy on LPS-Induced Aspiration Pneumonia in Mice.

Respiratory-related dysphagia and aspiration pneumonia can be attributed to multiple causes. However, reproduction of multiple factor-related respiratory distress and aspiration pneumonia in a single animal model is challenging. To validate animals with vagal nerve palsy as novel models for severe aspiration pneumonia associated with respiratory distress, we investigated the effects of unilateral vagotomy on the swallowing function and severity of pneumonia after forced aspiration in mice. Unilateral vagotomy was performed in C57BL6 male mice that subsequently underwent evaluation of swallowing function by videofluoroscopic swallow study (VFSS) and histological assessments for aspiration pneumonia induced by lipopolysaccharide (LPS). VFSS examinations demonstrated that unilateral vagotomy did not cause apparent aspiration in mice, but it resulted in a significant loss of body weight (BW) due to decreased oral intake. In addition, when aspiration pneumonia was induced by forced administration of LPS, significantly prolonged BW loss and severe infiltration of inflammatory cells associated with aspiration pneumonia were observed in the mice that underwent unilateral vagotomy. In conclusion, the vagotomized mice showed appropriate characteristics as a model of aspiration pneumonia caused by multiple factors, including the paralysis of vocal fold movement and respiratory distress. This model can help elucidate the pathogenesis of aspiration pneumonia and the treatment methods for the respiration-compromised model.

Origami With Rotational Symmetry: A Review on Their Mechanics and Design

Abstract Origami has emerged as a powerful mechanism for designing functional foldable and deployable structures. Among various origami patterns, a large class of origami exhibits rotational symmetry, which possesses the advantages of elegant geometric shapes, axisymmetric contraction/expansion, and omnidirectional deployability, etc. Due to these merits, origami with rotational symmetry has found widespread applications in various engineering fields such as foldable emergency shelters, deformable wheels, deployable medical stents, and deployable solar panels. To guide the rational design of origami-based deployable structures and functional devices, numerous works in recent years have been devoted to understanding the geometric designs and mechanical behaviors of rotationally symmetric origami. In this review, we classify origami structures with rotational symmetry into three categories according to the dimensional transitions between their deployed and folded states as three-dimensional to three-dimensional, three-dimensional to two-dimensional, and two-dimensional to two-dimensional. Based on these three categories, we systematically review the geometric designs of their origami patterns and the mechanical behaviors during their folding motions. We summarize the existing theories and numerical methods for analyzing and designing these origami structures. Also, potential directions and future challenges of rotationally symmetric origami mechanics and applications are discussed. This review can provide guidelines for origami with rotational symmetry to achieve more functional applications across a wide range of length scales.

Deep Neuromuscular Block for Endolaryngeal Surgery: A Systematic Review and Meta-Analysis.

To determine the safety and efficacy of deep neuromuscular block (NMB) for endolaryngeal surgery. PubMed, Web of Science, Cochrane Library, Ovid Medline, Embase, China National Knowledge Infrastructure, Wanfang, VIP databases, and trial registry database. Inclusion criteria followed the PICOS principles: Participants, adults undergoing endolaryngeal surgery; Intervention, deep NMB performed during the surgery; Control, no-deep NMB performed; Outcomes, primary outcome: the incidence of clinically acceptable surgical conditions. the incidence of intraoperative complications (including vocal fold movement and coughing) and total incidence of postoperative complications [including postoperative residual curarization (PORC), postoperative sore throat (POST), and postoperative nausea and vomiting (PONV)]. Study design, randomized controlled trials (RCTs). Duplicate publications, editorials, letters, abstracts, and reviews were excluded. Four articles with 242 patients were identified for analysis. The results indicated that compared with no-deep NMB, deep NMB provides a higher incidence of clinically acceptable surgical conditions (98.36% vs. 76.67%; relative ratio [RR]=1.29, 95% CI: 1.07-1.56), a lower incidence of intraoperative complications (10.83% versus 37.16%; RR=0.32; 95% CI: 0.21-0.49) (lower incidence of vocal fold movement [1.85% vs. 34%; RR=0.08, 95% CI: 0.02-0.41] and coughing [15.53% vs. 38.78%; RR=0.42, 95% CI: 0.27-0.66]). There were no differences in the overall incidence of postoperative complications (RR=2.10, 95% CI: 0.12-36.40). Based on current published evidence, deep NMB provides better surgical conditions with a higher incidence of clinically acceptable surgical conditions and a lower incidence of intraoperative complications (lower incidence of vocal fold movement and coughing) without increasing the overall incidence of postoperative complications. 1 Laryngoscope, 133:2055-2065, 2023.

A systematic review and meta-analysis on the outcomes of type I thyroplasty in the irradiated neck

BackgroundType I thyroplasty has been well-documented as a safe and effective treatment modality for vocal fold motion impairment, as well as other select cases of persistent glottic insufficiency. However, history of prior radiation to the neck has traditionally been viewed as a relative, if not formal contra-indication to this procedure. The objective of this systematic review was to analyze all available data in the literature on type I thyroplasty in previously irradiated patients and perform a meta-analysis assessing whether complications and revision rates are significantly different between radiated and non-irradiated patients. Secondary outcomes were to compare voice outcomes between these cohorts. MethodsSeveral databases were screened for relevant citations using the PICO process. The quality of studies and risk of bias were evaluated using the MINORS scoring system. Main endpoints for analysis in this study were complication rate and revision rate. Secondary endpoint was reported voice outcome. ResultsThree articles were included in the analysis. Zero major complications were reported, including no instances of implant extrusion or explantation. There was an 11.8 % rate of minor complications. There were similar rates of revision between radiation and control groups. There was no significant difference in voice outcomes between groups. The average MINORS score of the studies suggested a high risk of bias. ConclusionsBased on limited quality evidence, this review suggests that type I thyroplasty is safe and feasible in carefully selected irradiated patients, with comparable complication and success rates as their non-irradiated cohorts. Further large-scale studies are warranted.

КРЕЙДОВИЙ РИФТОГЕНЕЗ У ГЕОЛОГІЧНІЙ ІСТОРІЇ УКРАЇНСЬКОГО СЕКТОРУ ЧОРНОГО МОРЯ

Within the Ukrainian sector of the Black Sea, the Albian-Cenomanian rift faults formed three large rift basins, which consisted of a system of grabens and half-grabens. One of the sublatitude rift basins occupied the modern Karkinit Trough, Krylov-Zmiiny Uplift, Gubkin Ridge and the Sulina Depression on the Odesa Shelf. The second sublatitude basin occupied the modern Tetyaev High, Sorokin Trough, Marine Continuation of the Crimean Folds and, apparently, the Crimean Mountains. The third rift basin extended from the northwest to the southeast and encompassed the Euxinian Graben, Andrusov Ridge, Eastern Black Sea Basin, and Shatskiy High. The greatest depth of the base of the rift sequence is observed in the central part of the Western Black Sea Basin, where it is 15.5–16.5 km. In the Eastern Black Sea basin, the maximum depth is 12.5–13.5 km. The shallowest depths of the base of the rift sequence are characteristic of the Kalamit Swell and the Marine Continuation of the Crimean Folds. During the Cenozoic phases of compression, almost all rift (half)grabens underwent intense folding and vertical movements from several hundreds of meters to 4–5 km. At the same time, most of the rift faults underwent partial or complete inversion.