Haldun Oguz

Combined intratympanic and systemic use of steroids for idiopathic sudden sensorineural hearing loss.

Objective: To compare hearing results in idiopathic sudden hearing loss patients treated with systemic steroids alone or combined intratympanic and steroids. Study Design: Prospective. Setting: Tertiary referral hospital. Patients: Idiopathic sudden sensorineural hearing loss patients. Interventions: The patients in the systemic therapy group received consecutive administration of 100 mg intravenous methylprednisolone in the first day, 80 mg/day oral prednisolone in 3 divided doses for the next 2 days, and continued with oral administration of steroids by tapering the dose 20 mg in every 2 days. The patients in the combined treatment group received intratympanic injection of methylprednisolone (an approximate dose of 0.5 ml of 125 mg/ml). A total of 5 injections on alternate days were performed. Main Outcome Measures: The mean and median PTA gains of systemic corticosteroid therapy (SCT) group were 7.5 and 5 dB at 5th day, 12.1 and 7.5 dB at 10th day, and 13.0 and 8.8 dB at 15th day. The mean and median PTA gains for combined treatment (CT) group were 12.5 and 7.5, 17.8 and 13.8, 21.8 and 20.0 dB, respectively. Results: Both the mean and the median PTA gains were statistically significantly different between SCT and CT groups. According to improved hearing results (more than 10 dB gain), there was statistically significant difference between SCT and CT groups. None of the patients had an important complication. Conclusion: The results of this study suggest that adding intratympanic methylprednisolone to systemic therapy increases the probability of hearing recovery in ISSHL patients.

Objective voice changes in nondysphonic Parkinson's disease patients.

OBJECTIVE To obtain objective acoustic analysis results from Parkinsons disease patients who do not have voice symptoms and to compare these results with those from age- and sex-matched control subjects. DESIGN Prospective. SETTING Tertiary reference hospital. METHOD The objective acoustic analysis results from 14 female Parkinsons disease patients with no voice symptoms were compared with those of 22 age- and sex-matched normal subjects. RESULTS Statistical analysis revealed no differences in mean fundamental frequency and shimmer values. However, differences in jitter values, loudness, and the harmonics to noise ratio were statistically significant between the two groups (p < .05). CONCLUSION With this study, it was shown that Parkinsons disease patients who do not have any voice symptoms have objectively different acoustic values than their age- and sex-matched controls. Clinicians must be aware of these initial findings on the voice changes of Parkinsons disease patients.

Infected inferior turbinate pneumatization

With the widespread utilization of endoscopic nasal surgery, the interest in nasal structures has increased. Inferior turbinate pneumatization is among the most rare causes of nasal obstruction. In the current literature, there are only ten reported cases of inferior turbinate pneumatization. A 52-year-old male patient presented with nasal obstruction, purulent nasal discharge, facial pain and headache. Anterior rhinoscopic examination showed bilateral middle and inferior turbinate hypertrophy and edema of the nasal mucosa. Computed tomography (CT) revealed bilateral frontal, anterior and posterior ethmoidal and maxillary sinusitis with bilateral concha media bullosa and right infected inferior turbinate pneumatization. In this report, infection of this rare anatomical abnormality is presented for the first time and documented with acoustic rhinometry, CT and peroperative photography.

Pediatric Vocal Fold Nodule Etiology: What Are Its Usual Causes in Children?

OBJECTIVES In this study, the relation between phonotrauma and presence of siblings and social activities was investigated, and the incidence of voice disorders in the mothers of children with vocal fold nodules was studied with objective (clinical voice analysis) and subjective (laryngostroboscopy, Voice Handicap Index) methods. METHODS Twenty-nine children with vocal fold nodules (age range 5-14 years), 45 age-matched children without any voice disorders as a control group, and their mothers were included in the study. All patients had laryngostroboscopy and clinical voice analysis, and their mothers filled out the Pediatric Voice Handicap Index. We noted the most common place or situation where children used their voice in excessively high volume according to their mothers, including home, school, sportive activities, and singing or reciting poem activities, to recognize the major cause of phonotrauma. In addition, presence of siblings was recorded. RESULTS It was found that 15 patients (51.7%) had younger siblings, seven patients (24.1%) had older siblings, five patients (17.2%) had both younger and older siblings, and two patients (6.8%) did not have any siblings. It was seen that excessive usage of high-volume voice at home had a correlation with presence of only younger siblings, and both younger and older siblings tended to cause phonotrauma at home (86.7%). Additionally, eight boys (44.4%) reported presence of sportive activities, whereas none of the girls had such an activity (P = 0.012). CONCLUSION Presence of siblings seems to be an important factor for vocal nodule formation. Maternal relationship does not seem to be a major factor for vocal misuse.

Long-term voice results of injection with hyaluronic acid-dextranomere in unilateral vocal fold paralysis.

Abstract Conclusion: Subjective and objective voice evaluation of patients injected with hyaluronic acid-dextranomere (HA-D) in the long term was not different from their preoperative values. HA-D injection does not provide an increase in the voice quality in the long term. Objective: This study was conducted to evaluate the long-term voice outcomes of injection with HA-D in patients with unilateral vocal fold paralysis (UVFP). Methods: Seventeen patients with UVFP underwent injection of HA-D. The patient group was composed of 13 women and 4 men with an age range of 34–56 years. The voice samples of patients were obtained before the injection and after the longest available follow-up. Long-term results were evaluated subjectively by the GRBAS scale and objectively by acoustic analysis. Results: The follow-up period was between 6 and 42 months. Fundamental frequency, jitter, and noise-to-harmonics ratio were decreased in the postoperative period. Shimmer was nearly the same. An increase in the S score and a decrease in R, B, and A scores were observed. Neither the GRBAS scale parameters nor the acoustic analysis results were statistically significantly different before injection and after long-term follow-up.