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Glossary
Note: Within a definition, words in italics are defined elsewhere in the glossary. Words beginning with * were coined or brought into the language of voice disorders by Dr. Bastian, or to our knowledge are used primarily by BVI physicians and Bastian-trained fellows. Please note that we may be adding terms to this list from time to time. Copyright © 2008 Bastian Voice Institute.
I3C: The
abbreviation for indole-3-carbinol,
a phytochemical (plant chemical) found in significant quantities
in cruciferous vegetables (cabbage, broccoli, cauliflower,
Brussels sprouts, kale, collards, kohlrabi). Capsules of I3C
may be purchased without prescription as a nutritional supplement.
This compound alters estrogen metabolism and the result is
anti-proliferative. I3C has been widely used as a treatment
for recurrent respiratory papillomatosis
(RRP), though BVI physicians have found the benefit in their
adult patients to be underwhelming.
Idiopathic:
Of unknown cause. This term is used most often in laryngology
to refer to vocal fold paralysis,
after a mass lesion along the course of the recurrent
laryngeal nerve is ruled out.
Indirect versus direct laryngoscopy:
Direct laryngoscopy refers to viewing the larynx directly,
in a straight line, through a hollow, lighted tube, with the
patient typically under general anesthesia. Indirect laryngoscopy
refers to visualization of the larynx with the patient sitting
in a chair, by using a mirror, fiberscope, videoendoscope,
or laryngeal telescope more in the manner of a perisocope
that “looks around the corner” – in this
case, the base of the tongue.
Indole-3-carbinol: See
I3C.
*Inflammatory stenosis:
Narrowing in a lumen or passageway caused by an inflammatory
process. This term is used most commonly at BVI to refer to
stenosis in the high trachea
or subglottis, thought to
be an incomplete expression of Wegener’s
Granulomatosis.
Injection laryngoplasty:
A procedure during which an implant in paste form, typically
a product called Cymetra™,
is injected through a needle and into the paralyzed
vocal fold. The purpose is twofold. The first is
to fatten the vocal fold so that it moves toward the other
vocal fold and diminishes the gap between them that is causing
the air-wasting dysphonia.
The second reason is to fortify the tissue so that the paralyzed
fold is less flaccid and can “stand up” to the
pressure from the other vocal fold and the air passing between
them.
Inpatient surgery: Surgery
performed in a hospital in which the patient is expected to
stay over at least one night. Most often, the patient reports
early the morning of surgery for admission to the hospital,
undergoes the procedure, and then is taken from recovery room
back to their hospital bed for one or more days of recovery.
*Integrative diagnostic
method: See Integrative
diagnostic model.
*Integrative diagnostic
model: This is a powerful methodology for diagnosis
developed and refined by Dr. Robert Bastian. In comprises
three parts: the voice-focused history;
assessment of vocal capabilities
and vocal limitations via elicitation;
and intense laryngeal examination.
Once these three parts of the evaluation are accomplished,
the information gleaned from them must be integrated and correlated
to arrive at a robust diagnosis. See also [internal link:
BVI’s diagnostic model/method for voice disorders].
Interferon (or alpha-interferon):
A glycoprotein produced especially in white blood cells in
response to stimuli such as exposure to virus, bacterium,
or parasite. Humans make endogenous (self-made) interferon
in relatively small amounts. Exogenous (made outside the body,
as by the pharmaceutical industry) interferon may be administered
to assist in fighting infection or cancer.
In laryngology, interferon has been used against HPV
infection that causes recurrent respiratory
papillomatosis (RRP).
Intermittent whisper
phonation: See Abductory
spasmodic dysphonia (AB-SD)
Intubation injury:
Injury, typically to the posterior part of both vocal folds,
caused by an endotracheal tube.
The latter may be used briefly during general
anesthesia for surgery, but may be in place for much
longer in persons suffering respiratory failure or neurological
injury. When severe, the hallmark vocal phenomenology is breathy-pressed
phonation.
*Involuntary inspiratory
phonation: A vocal phenomenon in which an involuntary
vocal sound is made when one breathes in. This is caused by
the vocal folds being unable to move fully apart during the
taking in of breath. In other words, the folds are positioned
somewhat in the voicing (adducted) position, even when one
wants to inhale. In some cases, involuntary inspiratory phonation
is heard only during the elicitations
of the vocal capability battery,
when the patient is asked to empty the lungs (breathe out
fully) and then to fill them completely as rapidly and quietly
as possible.
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