Assessment of effectiveness of acoustic analysis of voice for monitoring the evolution of vocal nodules after vocal treatment.

In the present study, we report the results of acoustic analysis of voice in 97 patients diagnosed with vocal nodules before and after the vocal logopedic treatment, to evaluate its effectiveness in monitoring the evolution. We analyzed five parameters: the mean fundamental frequency (F0) and its standard deviation, jitter, shimmer, and normalized noise energy (NNE). Our results indicate that most patients showed a reduction of fundamental frequency, an increase of perturbation (jitter and shimmer), and an increase of NNE before the treatment. We did not find any statistically significant relationship between previous values of the five parameters analyzed and the clinical course. We did not find significant differences between the two groups (with and without clinical improvement) in the evolution of any of the five parameters, although these differences were greater in the case of jitter. We conclude that the acoustic analysis of voice can be useful as a complementary tool in the diagnosis of vocal nodules, but the parameter values analyzed before treatment did not correlate with the clinical course and we believe that its usefulness in the evaluation of results after the vocal treatment is limited.

[Parotid pneumocele in Down's syndrome]. / Neumocele parotídeo en el síndrome de Down.

Pneumoparotiditis is related to the cause of an infrequent increase in the size of the parotid gland due to the entrance of air through the Stenon duct following an increase in the pressure in the oral cavity. It is observed in musicians who play wind instruments, glass blowers, patients undergoing diagnostic or therapeutic techniques, in adolescents that provoke it intentionally, and in mentally handicapped people as found in the clinical case reported here. The symptoms are usually non-specific and the diagnosis is confirmed with an axial tomography. The interest in this clinical case lies in the peculiar form of presentation and its diagnostic confirmation through the use of CT imaging.

[Tracheotomy in children]. / Traqueotomía infantil.

OBJECTIVE: To inspect and describe the results of tracheotomies carried out at our ENT Department and to assess changes in indications over the last few decades. MATERIAL AND METHODS: Retrospective study of 13 patients, aged 3 months to 14 years, admitted by the ENT Department to the Paediatric ICU at Puerta del Mar University Hospital for elective tracheotomy over a 92-month period. RESULTS: The main indication is shared by obstructive respiratory insufficiency, post-surgery extubation failure and as a means of assisting ventilation in children requiring prolonged intubation. CONCLUSIONS: In the last 30 years the indications for paediatric tracheotomy have changed and the number of children needing intubation for more than 20-30 days has increased. It is no longer an emergency procedure to overcome a blockage in the upper airways but has instead become a technique for maintaining assisted ventilation for the medium to long term.