Voice quality after thyroplasty type I using a silicone block.

AIM: The aim of the work was to evaluate the voice quality of 10 adult patients after thyroplasty type I using a silicone block. Preoperatively patients suffered from unilateral vocal fold paralysis. MATERIAL AND METHODS: We evaluated selected preoperative and postoperative patient findings (RBH according to Wendler classification, videolaryngostroboscopy and maximum phonation time MPT). The evaluation was performed by a phoniatrician and clinical speech therapist, using patient medical records and the Lingwaves and Glottis Analysis Tools (GAT) programs. RESULTS: Preoperatively we identified R1B1H1 - R3B3H3, postoperatively R0B0H0 - R3B3H2. In six cases the paralysed vocal cord was preoperatively in a paramedian position, twice in intermediate position and twice in a lateral position. In the case of 6 patients presbyphonic changes were present. Motility of the healthy vocal cord was within the norm. Postoperatively, the paretic vocal cord was medialised. We assessed the MPT value: preoperatively 3‒10 seconds, postoperatively 9‒17 seconds. Postoperatively we measured jitter (%), shimmer (%) and closing quotient values. In comparison with healthy subjects (Inwald et al. 2011), jitter and shimmer values were higher and closing quotient values after thyroplasty type I close to normal values (Tab.1). CONCLUSIONS: The postoperative voice quality was significantly better in comparison with the preoperative state; though, it never achieved the parameters of a normal voice. We confirmed the significant contribution of TPL I for the patients´ quality of life through partial rehabilitation of their voices.

Hereditary bilateral sudden sensorineural hearing loss.

OBJECTIVES: The aim of our study is to demonstrate a causal link between two distinct diagnoses, the hereditary hearing loss, and the sudden sensorineural hearing loss. BACKGROUND: Sudden sensorineural hearing loss is an emergency condition in otolaryngology and a rare diagnosis in childhood. Most often it only affects one ear and its cause remains unknown. METHODS: We present a clinical study of a 10-year-old female patient presenting with bilateral sudden sensorineural hearing loss analyzed by Sanger sequencing of the GJB2 gene. RESULTS: The subject was referred to the hospital for bilateral sudden hearing loss which developed 3 days before the admission. Audiometric testing confirmed bilateral asymmetric sensorineural hearing loss. All routine diagnostic procedures including MRI and CT imaging showed normal results. She was treated with intravenous and intratympanic corticosteroids followed by hyperbaric oxygen therapy with partial hearing recovery in one ear. DNA analysis of the GJB2 gene identified biallelic c.35delG deletion. The subject had no other affected family members and her auditory development to that time was normal. CONCLUSION: Our finding extends the knowledge on phenotype variability in GJB2 variants. We suggest considering genetic testing in pediatric cases of bilateral sudden sensorineural hearing loss (Tab. 1, Fig. 4, Ref. 24).

Adjuvant therapy with hydrolytic enzymes in recurrent laryngeal papillomatosis.

The subject of this study is systemic enzymotherapy as adjuvant treatment in recurrent laryngeal papillomatosis. The authors analyze their observations of 5 adult patients with recurrent laryngeal papillomatosis when after surgical extirpation and subsequent application of peroral proteases there was a significant improvement of their clinical state and laboratory results. The patients have been disease-free from 10 to 18 months. In the authors' experience, the adjuvant enzymotherapy seems to be a suitable replacement of the supplementary treatment in larynx papillomatosis, and it promises to decrease the recurrence rate as well.