The Evaluation of Beck Anxiety Scale, Voice Handicap Index, and Brief Symptom Inventory on Treatment of Patients With Vocal Fold Nodules.

INTRODUCTION: Vocal fold nodules are benign lesions that cause hoarseness in all age groups including children, adolescents, and adults. These nodules may be caused either by singing or other causes of tension in vocal activity. OBJECTIVE: The aim of this study was to evaluate the psychological symptoms of adult patients with hoarseness and to investigate the relationship in psychological symptoms before and after voice therapy. METHODS: 23 Patients who were admitted with a voice complaint and diagnosed with vocal fold nodules and a matched control group were evaluated. Two inventories recommended by our psychiatrist (The Beck Anxiety Inventory, Brief Symptom Inventory) and Voice Handicap Index-10 (VHI-10), were completed to evaluate the treatment outcomes and psychosocial properties of the patients before and after voice therapy. RESULTS: A significant difference was observed in the BAI and BSI scores between the nodule (+) group and the control group at the beginning of the study, before voice therapy. A significant difference was found between the mean scores on the BAI and the BSI before and after therapy in the vocal fold nodules group. CONCLUSION: Patients with vocal fold nodules should be evaluated more extensively using psychological assessment scales, such as the BSI, and a psychiatric consultation should be added in cases of abnormal findings.

Psychometric Evaluation of Adapted Transsexual Voice Questionnaire for Turkish Trans Male Individuals.

AIMS: This study aims to evaluate the psychometric properties of the adapted transsexual voice questionnaire for male-to-female (a-TVQFtM) for trans male individuals in order to determine the suitability for use in research and clinical practice among Turkish trans male individuals. METHODS: This study was conducted by the Gender Dysphoria Clinic and Voice Clinic of a tertiary hospital referral center. The a-TVQFtM, voice-related quality of life, and self-perception of voice masculinity rating scale were administered to 50 trans male individuals, of whom 27 were hormone naïve and 23 were undergoing hormone treatment. Psychometric properties were investigated with reliability and validity analysis. RESULTS: The a-TVQFtM showed a strong internal consistency; the Cronbach's alpha coefficient for overall a-TVQFtM was 0.975, anxiety and avoidance factor was 0.948, vocal identity factor was 0.940, and vocal function factor was 0.923. No item needed to be deleted following adaptation. The a-TVQFtM scores showed a significant strong inverse correlation with the overall voice-related quality of life scores and the self-perception of voice masculinity rating (r = -0.863, r = -0.715, and P<0.001, respectively). The a-TVQFtM scores were significantly reduced in trans male individuals undergoing hormone treatment when compared with hormone naïve individuals. CONCLUSION: Although not specifically designed for trans male individuals, the current results provide confidence as to the psychometric properties of a-TVQFtM and, therefore, its suitability for use with Turkish trans male individuals.

Does Dysphagia Improve Following Laryngeal Reinnervation for Treatment of Hoarseness in Unilateral Vocal Fold Paralysis?

PURPOSE: There are many reports of the efficacy of laryngeal reinnervation on voice, but there is a paucity of literature regarding its impact on swallowing function. The goal of this study was to explore the impact of laryngeal reinnervation on swallowing outcomes among unilateral vocal fold paralysis (UVFP) patients. METHODS: We reviewed 22 UVFP cases treated with laryngeal reinnervation at our institution. Ten patients had complete datasets, including Eating Assessment Tool (EAT-10) scores and appropriate follow-up. Wilcoxon signed-rank test was used to compare pre- and postoperative scores. RESULTS: Over the study period, 10 cases (mean age 45.7 ± 13.3 years; 6/10 men) with UVFP underwent ansa cervicalis to recurrent laryngeal nerve anastomosis (6/10) or nerve-muscle pedicle procedure (4/10). The median time between injury and surgical reinnervation was 12.4 months (range 2.7-88.5 months). Based on EAT-10 scores 6/10 patients were found to have dysphagia. Of these, four improved their score after surgery, one remained stable, and one deteriorated. The median EAT-10 score of these patients improved from 13 to 7 after surgery, but this difference was not statistically significant (P = 0.138). CONCLUSION: Laryngeal reinnervation procedure has the potential for restoring a near normal voice in UVFP. Laryngeal reinnervation of the vocal fold may be associated with a tendency toward improvement in the EAT-10 score in patients after surgery for hoarseness in the setting of UVFP.

Reliability and validity of the Turkish version of the Vocal Fatigue Index

Background/aim: The aim of this study is to evaluate the reliability and validity of the Turkish version of the Vocal Fatigue Index (VFI). Materials and methods: The study was conducted with 535 participants including 285 patients with voice disorders and 250 healthy controls. Internal consistency and test-retest reliability were calculated for the reliability analysis. The mean VFI factor scores of both groups were compared. The strength and direction of the relation between VFI and Voice-Related Quality of Life (V-RQOL) measure was evaluated for the validity analysis. Results: The Cronbach's alpha coefficient of VFI factor scores was found to be 0.920 for tiredness and avoidance of voice use, 0.879 for physical discomfort with voice use, and 0.882 for improvement of symptoms with voice rest. The test-retest reliability revealed 0.877 for the tiredness and avoidance of voice use, 0.913 for the physical discomfort with voice use, and 0.820 for the improvement of symptoms with voice rest. When compared with healthy individuals, VFI factor scores were statistically significant higher in patients with voice disorders. The V-RQOL scores decreased significantly as the VFI scores increased. Conclusion: The Turkish version of the VFI is a good reliable and valid instrument for evaluating vocal fatigue symptoms in the Turkish-speaking community.

Functional constipation as a neglected condition in laryngectomized patients.

BACKGROUND/AIMS: When considering the quality of life of patients who undergo total laryngectomy, constipation problems are often overlooked. This study aims to determine whether surgical or concurrent chemoradiotherapy treatments matter in the development of functional constipation in patients with advanced-stage laryngeal cancer. MATERIALS AND METHODS: Patients without presurgical constipation (according to Rome IV) who were treated with either surgery (n=30) or chemoradiation (n=25) were evaluated for constipation development. Interim evaluation and recommendations were made on the 3rd month. On the 3rd and 6th months, the frequency of constipation between groups was compared using the Rome IV criteria and European Organization for Research and Treatment of Cancer Quality of Life Scale-C30 constipation symptom score. RESULTS: On the 3rd month, the frequency of constipation was higher in the surgery group than in the chemoradiation group (76.7% vs. 28%, p<0.001). On the 6th month, although still higher, the frequency of constipation decreased following the recommendations in laryngectomized patients (56.7% vs. 36%, p=0.17). C30 Constipation "yes/no" inquiry failed to detect 11 (36.6%) and 8 (26.6%) laryngectomized patients with constipation on the 3rd and 6th months, respectively. CONCLUSION: Constipation is more frequent and develops in the early period of postlaryngectomy. Patients seem to benefit from additional special rehabilitation recommendations. Constipation-prone laryngectomized patients should be screened with the Rome IV criteria, which effectively detect constipation.

Laryngoscopic Examination During the COVID-19 Pandemic: Turkish Voice Speech and Swallowing Disorders Society and Turkish Professional Voice Society Recommendations.

COVID-19 is highly transmissible and spreads rapidly in the population. This increases the occupational risk for health care workers. In otolaryngology clinic practice, patients with upper respiratory tract infection symptoms are common. Also, routine head and neck examinations such as oral cavity examination, nasal/nasopharyngeal examination, or video laryngostroboscopic evaluation are highly risky because of the aerosol formation. To emphasize this issue, two leading otolaryngology organizations in Turkey; 'Voice Speech and Swallowing Disorders Society', and 'Professional Voice Society' gathered a task force. This task force aimed to prepare a consensus report that would provide practical recommendations of the safety measurements during routine clinical care of laryngology patients. To fulfill this, universal aim, on the 2nd and 9th of May 2020, two web-based meetings were conducted by 20 expert physicians. This eighteen items list was prepared as an output.

Psychosocial effects of otoplasty in adult patients: a prospective cohort study.

OBJECTIVE: This prospective study investigated changes in psychosocial status following otoplasty. METHODS: All patients who participated in the study filled a sociodemographic form that included age, gender, educational status and job preoperatively. Body Image Scale (BIS), Social Appearance Anxiety Scale (SAAS) and Rosenberg Self-Esteem scale (RSES) were completed prior to surgery and 6 months postoperatively. RESULTS: A total of 20 patients completed psychometric measures of body image, social appearance anxiety, and self-esteem. Of the patients (6 males, 14 females) whose charts were reviewed, the mean age was 24.05 ± 8.25 years (median 22 years: range 18-49) years. Six months post operatively BIS total scores were increased significantly relative to that of the baseline values (p = 0.005).SAAS scores were decreased significantly relative to that of the baseline values (p = 0.003). Although the postoperative RSES score tended to improve, it was not significantly different from the baseline value. The RSES scores showed significantly strong correlation with the SAAS scores (p < 0.001) and moderate correlation with the BIS scores at baseline (p = 0.013). None of the patients admitted for surgery had low self-esteem at baseline, with all patients categorized as having either moderate (n = 10, 50%) or high (n = 10, 50%) self-esteem. Following surgery, only one patient improved from moderate to high self-esteem. The baseline and postoperative BIS, SAAS, and RSES scores did not significantly differ between women and men. None of the other sociodemographic characteristics showed significant relationships with the three scales. CONCLUSIONS: Otoplasty can provide significant positive psychosocial benefits, even in an adult population. Therefore, this type of surgery should be offered to any patient seeking a solution to prominent ear-related psychosocial problems regardless of age.

Benign mixed tumour of the breast and breast skin, two cases with diagnostic difficulties.

We present two cases of pleomorphic adenoma, one that developed in the breast parenchyma and the other in the breast skin, with their histopathological differential diagnosis.

Efficacy of sublingual immunotherapy for house dust mite allergic rhinitis.

In the present study, we investigated the outcomes of sublingual immunotherapy (SLIT) in house dust mite-induced allergic rhinitis (HDM-AR) patients. In this prospective, multicentric study, 186 patients with AR who had positive skin prick test results for HDMs were included. The patients were administered SLIT using Staloral 300 for 1 year. Evaluation of the patients regarding symptom scores, clinical findings and Rhinitis Quality of Life Questionnaire (RQLQ) scores was performed at baseline, and then at 6 and 12 months of therapy. Our results showed that, for all of the evaluated items (symptom scores, clinical findings and RQLQ scores), 12-month values were significantly lower than those at 6 months and baseline. Similarly, 6-month values were significantly lower than those at baseline. There were no complications in any of our patients. SLIT for HDM-AR is a treatment modality that can be used safely. We obtained better results than expected, and the treatment showed a positive psychological effect; the patients believed that SLIT was the final step of treatment and, which made them feel better.