Flávio A. P Settanni

Noise-to-Harmonics Ratio as an Acoustic Measure of Voice Disorders in Boys ☆

This prospective study assessed the efficacy of computerized noise-to-harmonics ratio (NHR) to quantify perceptual and endoscopic findings of dysphonia and/or structural lesion of the vocal fold. Fifty Brazilian boys without vocal complaints were submitted to computerized, perceptual, and endoscopic examination. Thirty boys were dysphonic--3 were classified into the grade category, 5 into breathiness, 9 into roughness, and 15 into grade/breathiness. Vocal fold lesions were observed in 25 boys (17 nodules and 8 cysts). The Mann-Whitney U test revealed that NHR was significantly higher in boys with a structural lesion (p = 0.007) and in boys with dysphonia (p < 0.0001). However, according to a logistic regression model, only the occurrence of dysphonia was explained by NHR; the risk for having dysphonia increased approximately twice (odds ratio = 1.92, 95% confidence interval = 1.3-2.9) with each increase of 0.01 in NHR. Our results suggest that noise is a useful quantitative index to confirm a perceptual diagnosis of dysphonia and to evaluate quantitative changes in a dysphonic voice over time. However, we believe that computerized analysis should be used as a complement, rather than a substitute, for perceptual evaluation. Further studies with a larger sample are required to investigate the relationship between noise and lesions of the vocal folds.

Isolated Schwannoma of the Olfactory Groove: A Case Report

Introductionu2003Schwannoma of the olfactory groove is an extremely rare tumor that can share a differential diagnosis with meningioma or neuroblastoma. Objectivesu2003The authors present a case of giant schwannoma involving the anterior cranial fossa and ethmoid sinuses. Case Reportu2003The patient presented with a 30-month history of left nasal obstruction, anosmia, and sporadic ipsilateral bleeding. Computed tomography of the paranasal sinuses revealed expansive lesion on the left nasal cavity extending to nasopharynx up to ethmoid and sphenoid sinuses bilaterally with intraorbital and parasellar extension to the skull base. Magnetic resonance imaging scan confirmed the expansive tumor without dural penetration. Biopsy revealed no evidence of malignancy and probable neural cell. Bifrontal craniotomy was performed combined with lateral rhinotomy (Weber-Ferguson approach), and the lesion was totally removed. The tumor measured 8.0u2009×u20094.3u2009×u20093.7 cm and microscopically appeared as a schwannoma composed of interwoven bundles of elongated cells (Antoni A regions) mixed with less cellular regions (Antoni B). Immunohistochemical study stained intensively for vimentin and S-100. Conclusionu2003Schwannomas of the olfactory groove are extremely rare, and the findings of origin of this tumor is still uncertain but recent studies point most probably to the meningeal branches of trigeminal nerve or anterior ethmoidal nerves.

Functional and electrophysiological evaluation of the effect of laser therapy in the treatment of peripheral facial paralysis

This clinical case report relates to a total of 4 patients, carriers of idiopathic facial paralysis, treated with Low Level Laser Therapy using a Gallium-Aluminum-Arsenide diode laser of 780 nm, 50 mW, continuous wave emission, spot size 3 mm2 and total dosage of 20 joules per session distributed to the peripheral trajectory of the injured nerve in a point by point contact mode. Altogether 24 treatment sessions were performed in a period of 12 consecutive weeks twice a week All treated patients presented recovery signs from the initial degree of paralysis.

Vocal quality evaluation in children without voice disorders: a prospective and double-blind study

Abstract In this study, 50 males from 3 to 10 years of age were examined with the aim of detecting voice disorders. Twenty-five of them were normal, eight had vocal cysts, and 17 presented with vocal nodules without any underlying laryngeal pathology. Perceptual auditory analyses and measures of phonatory function were performed by a trained speech therapist. Normal vocal quality was significantly more frequent in the normal group; roughness and breathiness were associated with the pathological groups (p