Unexpected discovery in the thyroid cartilage during voice deepening surgery.

Voice deepening surgery has en increasing interest among laryngologist worldwide and a case of surprising foreign body in the thyroid cartilage awakes alert thoughts of awareness to certain patient group.

Receiver operating characteristic analysis of acoustic and electroglottographic parameters with different sustained vowels.

OBJECTIVE: To examine the power of the parameters obtained from different sustained vowels used in acoustic and electroglottographic (EGG) voice evaluation protocols to discriminate between dysphonic and non-dysphonic voice quality. METHODS: Sixty non-dysphonic participants and 30 dysphonic participants were included in the study. In addition to the time domain amplitude and frequency perturbation parameters obtained from the sustained phonation of /ʌ/-/ɛ/-/i/-/u/ vowels, several frequency-domain spectral/cepstral parameters and EGG parameters were evaluated. The classification performance of the acoustic and electroglottographic measures was quantified using analysis and receiver operating characteristic (ROC) curve analysis. RESULTS: As a result of ROC analysis, the discriminative diagnostic performance (area under the curve, AUC) of the test for low-vowel (/ʌ/-/ɛ/) phonation was higher than values obtained from high-vowel (/i/-/u/) phonation. For /ʌ/ and /ɛ/ sustained vowels, the parameters exhibiting the highest discrimination were fundamental frequency standard deviation (fo/STD), cepstral peak prominence (CPP), relative average perturbation (RAP), pitch perturbation quotient (PPQ), and jitter percent (JITT). In the EGG parameters, on the other hand, average jitter and periodicity parameters obtained from front vowels (/ɛ/-/i/) were found to have higher AUC values compared to back vowels (/ʌ/-/u/). CONCLUSIONS: In acoustic analyses, /ʌ/ and /ɛ/ sustained vowels give the highest diagnostic performance. In the electroglottographic evaluation, on the other hand, /ɛ/ and /i/ vowels, when the position of the tongue is forward, have better classification performance compared to /ʌ/ and /u/ vowels, when the position of the tongue is back.

Clinical Considerations in Speech and Language Therapy in Turkish Transgender Population.

OBJECTIVE: Transgender people aim to increase and improve their quality of life by demanding voice and communication intervention services, however clinical recommendations regarding assessment and intervention in the transgender population are based on others' practice, experiences, assumptions. The present study aims to give clinical considerations in speech and language therapy for transgender populations. METHOD: Thirty-one transgender subjects were taken in to the present study after applying exclusion criteria. Participants were excluded: • If they do not define themselves as transgendered and have not taken part in any reassignment of gender procedure and also they do not want to take part in any gender procedures. The participants were given a survey, which included questions related to demographic information, procedures during transition process, priorities regarding to voice and nonverbal communication and as a final part awareness and knowledge in speech and language therapy. RESULTS: Transgender people had benefited from many procedures and/or approaches during their transition process from hormone therapy to voice surgery. Participants stated that pitch was the most important vocal quality among others (41.9%) while facial expression (38.7%) was the most important one among other nonverbal communication skills. None of the participants had speech and language therapy sessions during their transition process. With regards to awareness of speech and language therapy services, 17 of the participants (54.8%) said they did not know that they could apply for the services. Twelve participants (38.7%) reported that they were aware of the services and they could apply in order to change their voice characteristics, nine participants (29%) informed that they could see a speech and language therapist for nonverbal communication skills while seven participants (22.6%) said it was for social language use. The participants who knew about speech and language therapy had knowledge about the therapy services via online resources. CONCLUSION: Transgender participants are not aware of speech and language therapy services in Turkey.

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.

Original Research: Aerosolized Lidocaine: Effective for Safer Arousal After Suspension Laryngoscopy.

AIM: To examine the systemic and local effects of the lidocaine on the larynx and trachea which is applied after the end of the surgery and through various application methods. STUDY DESIGN: Randomized controlled prospective study. METHOD: The study is composed of patients who underwent suspension laryngoscopy (SL) for benign laryngeal diseases (cysts, polyp, granuloma, etc) and American Society of Anesthesiologists (ASA) I, between January 2017 and January 2018. The patients were randomly divided into 3 groups. In the first group nothing is applied at the end of the surgery and called as control group, second group received 7 pufs of aerosolized 10% lidocaine solution (70 mg) over larynx and trachea and third group received cotton swaps that impregnated in 1 ml of 20 mg lidocaine solution over surgical area for 1 minutes. Operation and arousal times, heart rate and mean arterial blood pressure levels were noted and compared. Also laryngospasm, cough, and agitation scores were obtained during arousal. RESULTS: 64 patients were included in the study. Laryngospasm was not observed in any of the patients. In group 2 (aerosolized lidocaine group), patients' blood pressure remained similar while increased in other groups (P < 0.05). Agitation scores were significantly lower in group 2 compared to the other groups (P = 0.012). Cough reflex is observed less in group 2 but result was not statistically significant (P = 0.13) CONCLUSION: The usage of aerosolized lidocaine after suspension laryngoscopy is very effective in blocking the stimulation of superior laryngeal nerve and sympathetic nerves which were responsible for the pressor reflexes. The inhibition of these reflexes before or during arousal could secure a safer arousal.

An Examination of Vocal Tract Acoustics following Wendler's Glottoplasty.

PURPOSE: To investigate the formant frequency (FF) features of transgender females' (TFs) voice after Wendler's glottoplasty surgery and compare these levels with age-matched healthy males and females. STUDY DESIGN: Controlled prospective. METHODS: 20 TFs and 20 genetically male and female age-matched healthy controls were enrolled in the study. The fundamental frequency (F0) and FFs F1-F4 were obtained from TF speakers 6 months after surgery. These levels were compared with those of healthy controls. RESULTS: Statistical analysis showed that the median F0 values were similar between TFs and females. The median F1 levels of TFs were different from females but similar to males. The F2 levels of TFs were similar to females but different from males. The F3 and F4 levels were significantly different from both male and female controls. CONCLUSION: Wendler's glottoplasty technique is an effective method to increase F0 levels among TF patients; however, these individuals report their voice does not sufficiently project femininity. The results obtained with regard to FF levels may be the reason for this problem. Voice therapy is recommended as a possible approach to assist TF patients achieve a satisfactory feminine voice.

Reliability and Validation of the Turkish Version of the Pediatric Voice-Related Quality of Life Survey.

OBJECTIVE: To evaluate the effect of dysphonia in children, several methods have been developed, including the Pediatric Voice Outcome Survey, the Pediatric Voice Handicap Index, and the Pediatric Voice-Related Quality of Life (PVRQOL) Survey. The aim of this study was to analyze the validity of the Turkish version of the PVRQOL Survey. METHODS: The PVRQOL Survey consists of 10 questions that evaluate the effects of dysphonia on quality of life. We translated it into Turkish by working with two translators and faculty from the English Grammar and Literature Department. The Turkish version was translated back into English by two bilingual individuals to assess accuracy. The final version was tested by 15 parents for pilot study. Following the pilot study, we enrolled 52 children who had been admitted to the outpatient clinic with dysphonia and 79 children who had no voice complaints. The parents of the children under 7 years were asked to answer the survey. Children aged between 7 and 9 years completed the survey with their parents, and children over 9 years completed the survey by themselves. RESULTS: The results of the pilot study revealed no difference between the two groups. Intergroup comparisons revealed that there were statistically significant differences between the control and patient groups in terms of question responses. When the total scores of the two groups were compared, there was a significant difference. CONCLUSION: The Turkish version is a valid and reliable instrument for assessing dysphonic patients and healthy subjects.

Efficacy of dexpanthenol for pediatric post-tonsillectomy pain and wound healing.

OBJECTIVES: We evaluated the efficacy of dexpanthenol in managing pediatric post-tonsillectomy pain and wound healing and sought to discover which of two surgical tonsillectomy techniques provides better healing and less postoperative pain. METHODS: One hundred twenty patients who underwent tonsillectomy were equally randomized to thermal welding and cold dissection groups. Dexpanthenol pastilles were given to half of each group. Postoperative throat pain was determined with a visual analog scale on the 1st, 3th, 7th, and 14th days, and mucosal healing patterns were assessed on the 7th and 14th days. RESULTS: Regardless of surgical technique, post-tonsillectomy throat pain was significantly less in the dexpanthenol groups than in the placebo groups (p < 0.05), and tonsillar wound healing was significantly better in the dexpanthenol groups than in the placebo groups (p < 0.05). When a comparison was made with regard to surgical technique, wound healing was significantly better in the cold dissection group (p < 0.05), whereas postoperative throat pain was less in the thermal welding group (p < 0.05). CONCLUSIONS: Postoperative administration of dexpanthenol significantly accelerates the wound healing process and decreases tonsillectomy-related pain complaints.

Voice disorder in patients with Fibromyalgia.

OBJECTIVE: To investigate several perceptual, acoustic and aerodynamic voice evaluation parameters in Fibromyalgia patients. METHODS: A total number of 30 Fibromyalgia patients had voice evaluations by means of laryngostroboscopy, acoustic analysis (jitter, shimmer, and harmonic to noise ratio), aerodynamic measurements (maximum phonation time, s/z ratio), and perceptual analysis (GRBAS and Voice Handicap Index-10 scales). Data obtained from the patients was compared to control subjects. RESULTS: Mean intensity was found to be significantly higher in control subjects (73.70±4.73dB) than Fibromyalgia patients (64.50±6.92dB), (p<0.001). There was no statistically significant difference in fundamental frequency, perturbation parameters (jitter and shimmer) and harmonic to noise ratio between groups. Maximum phonation time in control subjects (22.53±4.95s) was found to be significantly longer than Fibromyalgia patients (16.07±4.87s), (p<0.001), and s/z ratio was found to be nearly equal between patients (1.00±0.24) and control subjects (0.96±0.16). On the basis of perceptual evaluation by using a GRBAS scale, the patients showed a mean score of 2.50±1.97 and the control group showed a mean score of 0.56±1.04 (p<0.001). "Grade" and "asthenia" parameters of GRBAS scale in Fibromyalgia patients were significantly different from the parameters of control group (p<0.001). The Voice Handicap Index-10 scales revealed a mean score of 7.90±7.58 in Fibromyalgia patients and 1.83±2.82 in control subjects (p<0.001). CONCLUSION: Fibromyalgia impairs perceived voice quality either in patient self evaluated or in clinician evaluated rating scales. Furthermore, the results confirm that Fibromyalgia caused short maximum phonation time and low voice intensity. This study is the first report with regards to voice evaluation in Fibromyalgia and in order to make a generalization further researches are needed.

Voice and speech changes in various phases of menstrual cycle.

BACKGROUND: The reproductive system in females undergoes a regular cyclic change known as the menstrual cycle. Laryngeal changes are evident and fluctuate systematically during the reproductive years with the menstrual cycle. The impact of estrogens in concert with progesterone produces the characteristics of the female voice, with a fundamental frequency (F(0)) higher than that of male. OBJECTIVE: To characterize changes in voice and speech in adolescent females in different phases of the menstrual cycle--during menstruation, after menstruation, mid-menstrual cycle, and premenstruation. MATERIALS AND METHODS: Sixteen adult females who were nonusers of oral contraceptives participated in a cross-sectional study of menstrual cycle influences on voicing and speaking tasks. Acoustic analysis (F(0), intensity, perturbation measurements [jitter and shimmer], and harmonic-to-noise ratio), maximum phonation time (MPT), s/z ratio, and perceptual assessments (grade [G], roughness [R], breathiness [B], asthenia [A], and strain [S] [GRBAS] and Voice Handicap Index-10 [VHI-10]) scales were performed during all phases. RESULTS: None of the acoustic analysis parameters and MPT and s/z ratio measurements revealed statistically significant difference (P > 0.05). Perceptual voice assessment scales either clinician based or patients self-evaluated showed significant differences among phases (P < 0.05). CONCLUSIONS: The objective voice analysis methods, such as acoustic analysis, MPT, and s/z ratio, determined no difference; however, the subjective voice analysis methods, such as clinician-based perceptual assessment (GRBAS) and patients self-evaluation (VHI-10) scales, demonstrated significant changes during different phases of menstrual cycle.

Comparison of transient and distortion-product otoacoustic emissions during the luteal and follicular phases of the menstrual cycle.

We conducted a study to examine cochlear activity in women with a naturally occurring menstrual cycle by measuring transient otoacoustic emissions (TOAEs) and distortion-product otoacoustic emissions (DPOAEs). Our study population was made up of 11 women aged 20 to 40 years (mean: 35.6) who were not taking a contraceptive medication or hormone therapy. Measurements of TOAEs and DPOAEs were made during both the follicular phase and the luteal phase of the menstrual cycle. We found no statistically significant difference in any of the TOAE amplitude values between the two phases. Although a sharp decrease at the 0.75 kHz frequency was seen in DPOAEs during both phases, none of the amplitude values in the tested frequencies were significantly different between the two phases. The absence of TOAE and DPOAE amplitude changes suggests that it is unnecessary to take into account the phase of the menstrual cycle when interpreting the results of otoacoustic emissions testing.

Behcet's disease impairs voice quality without laryngeal and hypopharyngeal involvement.

The objective of the study was to investigate voice evaluation parameters in Behcet's disease patients. A prospective controlled study was performed in a tertiary referral center. A total of 31 patients (21 female, 10 male) with a diagnosis of Behcet's disease had voice evaluations by means of laryngostroboscopy, acoustic analysis, aerodynamic measurements and perceptual assessment. Data obtained from the patients were compared to 31 healthy control subjects. Laryngeal endoscopy was within normal limits in all patients. The mean fundamental frequency in male control subjects (134 ± 14 Hz) was significantly higher than in male patients (124 ± 20 Hz), (p = 0.043). Mean intensity was significantly higher in control subjects (74 ± 5 dB) than in the patients (63 ± 4.6 dB), (p < 0.001). Shimmer in patients (3.4 ± 2.5) was significantly higher than in control subjects (2 ± 1.3), (p = 0.01). Maximum phonation time in control subjects (25 ± 5.8 s) was significantly longer than in patients (20 ± 7.9 s), (p = 0.007), and s/z ratio was found to be nearly equal between patients (0.9 ± 0.2) and control subjects (0.96 ± 0.1), (p > 0.05). The patients showed a mean GRBAS score of 1.8 ± 1.9 and the control group showed a mean score of 0.48 ± 1.06, (p = 0.002). The VHI-10 scale revealed a mean score of 2.2 ± 4.8 in BD patients and 2 ± 2 in control subjects (p > 0.05). Behcet's disease impaired voice quality without laryngostroboscopically visible laryngeal and hypopharyngeal involvement. This impairment was documented by objective voice evaluation methods including acoustic analysis and aerodynamic voice measurements and by subjective voice evaluation method including perceptual assessment.

Manganese-superoxide dismutase and glutathione peroxidase 1 polymorphisms in recurrent tonsillitis and tonsillar hypertrophy.

OBJECTIVES: To investigate the association of manganese-superoxide dismutase and glutathione peroxidase 1 polymorphisms with susceptibility to recurrent tonsillitis and tonsillar hypertrophy. METHODS: The study consisted of 103 patients with recurrent tonsillitis, 105 patients with tonsillar hypertrophy and 106 control subjects with similar age and sex. Genomic DNA was extracted from peripheral leukocytes of whole blood which were obtained from all patients and control subjects. Genotyping was performed to identify MnSOD Ala-9Val and GPx1 Pro198Leu polymorphisms by a method based on PCR amplification and detection of polymorphisms with hybridization probes labeled with fluorescent dyes. Genotype and allele frequencies were compared between patients with recurrent tonsillitis and tonsillar hypertrophy and 106 healthy control subjects. RESULTS: The genotype distribution of the MnSOD Ala-9Val single nucleotide polymorphism was significantly different for the controls and the recurrent tonsillitis patients (P=0.009). Whereas, no significant difference was found between the patients with tonsillar hypertrophy and the control group (P=0.369). The frequency of the MnSOD CC genotype was lower, and that of the T allele was significantly higher, in recurrent tonsillitis patients than in control subjects. In addition, the frequency of tonsillitis was significantly higher in recurrent tonsillitis patients with the MnSOD Ala-9Val polymorphism than the patients with wild-type (P=0.008). Also, no significant difference was found between patient groups and control subjects in the distribution of the genotype and allele frequency of the GPx1 Pro198Leu single nucleotide polymorphism. CONCLUSIONS: The MnSOD Ala-9Val polymorphism causes susceptibility to recurrent tonsillitis in Turkish children. And we suggest that there may be a possible relation between local and recurrent infections or inflammation of the tonsillar tissue and the MnSOD Ala-9Val single nucleotide polymorphism in pediatric patients with RT.

Septorhinoplasty with spreader grafts enhances perceived voice quality without affecting acoustic characteristics.

OBJECTIVE: To identify the effect of septorhinoplasty with spreader grafts on patients' perception of voice and to measure formant frequencies that may be responsible for perceived changes in voice quality. METHODS: A total of 20 patients who underwent septorhinoplasty and had spreader grafts placed during the operations were included. All subjects were tested within the week before surgery and 1-3 months postoperatively by means of perceptual assessment (Voice Handicap Index-10 [VHI-10] and self-assessment of hypo/hypernasality), acoustic analysis, and formant frequency analysis. RESULTS: The mean of VHI-10 score was decreased from 9.44±6.1 to 5.1±3.94 postoperatively (P=0.03). Fifteen patients (75%) perceived their voices to be hyponasal before surgery, but only three perceived the hyponasality to persist after surgery (P<0.001). No patient perceived the voice to be hypernasal either before or after surgery. Fifteen patients (75%) perceived their overall voice quality to be improved, whereas five patients perceived no change. None of the patients perceived their voice to be worse after surgery. There were no significant differences between pre- and postoperative acoustic analysis and formant frequency analysis (P>0.05). CONCLUSION: Septorhinoplasty with spreader grafts significantly improved patients' perception of voice; however, acoustic analysis and formant frequency analysis of nasalized vowels did not reveal any significant differences after the operation.

The effectiveness of steroids for edema, ecchymosis, and intraoperative bleeding in rhinoplasty.

BACKGROUND: The aim of this study was to investigate the dose-related effectiveness of steroids on periorbital edema, ecchymosis, and intraoperative bleeding in patients who underwent open rhinoplasty with osteotomy. METHODS: Forty patients were divided into three groups: those in group 1 (n = 15) were given a single dose of 1-mg/kg intravenous (i.v.) methylprednisolone, those in group 2 (n = 15) were given a single dose of 3-mg/kg i.v. methylprednisolone preoperatively, and group 3 (n = 10) was the control group. Eyelid edema and periorbital soft-tissue ecchymosis were evaluated separately using a scale of 0-4. RESULTS: In groups using the steroid preoperatively, periorbital edema and ecchymosis were significantly lower compared with the control group (p < 0.05). No significant differences were seen clinically or statistically in preventing or reducing either the periorbital ecchymosis or the periorbital edema between groups 1 and 2. Also, there was no significant difference among the groups in terms of bleeding (p > 0.05). No complications with regard to the operation or steroid use were observed. CONCLUSION: Our results support that steroids significantly decrease periorbital ecchymosis and periorbital edema in open rhinoplasty with osteotomy. Additionally, our results suggest that if the dose of steroids is adjusted according to body weight, there is no significant benefit in a single dose of 3 mg/kg of methylprednisolone over a lower dose of 1 mg/kg and there is no need for higher doses of methylprednisolone administration.

Effects of neck dissection and radiotherapy on short-term speech success in voice prosthesis restoration patients.

OBJECTIVE: To compare the short-term speech success of voice prosthesis (VP) among patients who underwent total laryngectomy or total laryngectomy in combination with neck dissection and those who received postoperative radiotherapy. MATERIALS AND METHODS: Thirty-two male patients treated for laryngeal squamous cell carcinoma were included. Nine patients underwent total laryngectomy and 23 underwent total laryngectomy combined with neck dissection, and 17 of the 23 with neck dissection were managed with postoperative radiotherapy (45-75 Gy). All of the patients had indwelling intraoperative placement of the Provox VP (Atos Medical AB, Horby, Sweden; and Entermed BV, Woerden, The Netherlands) at the time of the primary tracheoesophageal puncture (TEP) completed in conjunction with total laryngectomy. Patients with pharyngoesophageal myotomy and pharyngeal plexus neurectomy were excluded. Patients' speech success was perceptually evaluated 3-4 weeks after the surgery and 3-4 weeks after the cessation of radiotherapy, using a 1-3 scale (1 = failure to develop speech (aphonia); 2=communicate with short phrases only; and 3 = communicate with fluency and long sentences). RESULTS: No complications were noted with intraoperative prosthesis placement. No prostheses were dislodged in the postoperative period. Eighteen of 32 patients (56%) demonstrated successful speech (rating of 3). Nine patients (28%) demonstrated less successful speech (rating of 2). Five patients (16%) were found to be aphonic (P > 0.05). Of the nine patients who underwent total laryngectomy only, six were found to have successful speech (66.6%), one (11.1%) was found to have less successful speech quality, and two (22.2%) patients were aphonic (P > 0.05). Of the six patients who underwent total laryngectomy in combination with neck dissection, three had successful speech (50%), one (16.6%) had less successful speech, and two (33.3%) were aphonic (P > 0.05). Of the 17 patients who received postoperative radiotherapy, nine (52.9%) had successful speech, three (17.6%) had less successful speech, and five (29.4%) were aphonic (P > 0.05). CONCLUSION: Neck dissection and postoperative radiotherapy have no significant influence on short-term speech success in VP restoration patients. Primary TEP should be preferred in patients who have laryngectomy in combination with neck dissection and/or will have postoperative radiation therapy, as it provides early and successful voice restoration without interfering with radiation treatment and avoids a second surgical intervention.

The comparison of bacteremia and amount of bleeding during adenotonsillectomy.

OBJECTIVE: Adenoidectomies and/or tonsillectomies are among the most frequently performed otolaryngological surgical procedures.The goals of this study were to investigate the relationship between the amount of bleeding and bacteremia during adenoidectomy and/or tonsillectomy procedures. METHODS: Seventy-eight patients who underwent tonsillectomy with or without adenoidectomy and adenoidectomy with or without tube insertion were included in the study. Patients with severe chronic underlying diseases (including cardiovascular disorders, renal or hepatic disease, or immunodeficiency) were excluded from study, as were those who had suffered an acute episode of respiratory infection or had received antibiotics for any reason within three weeks prior to the operation. The amount of bleeding was measured and recorded for each patient during the surgery. Preoperative blood cultures immediately after the induction of anesthesia and postoperative blood cultures 20 min after the operation were collected. RESULTS: While none of the blood cultures taken preoperatively was positive for any organisms, the cultures obtained postoperatively were positive in 16 (20.5%) of 78 patients who underwent tonsillectomy with or without adenoidectomy and adenoidectomy with or without tube insertion, and bacteremia was more frequent among those with greater amount of bleeding during the surgery. CONCLUSION: The results of this study suggest that although bacteremia had no clinical consequences in patients, it should be kept in mind that patients with greater amount of bleeding are at higher risk for developing bacteremia and it may produce vital results in patients at risk.

Thermal welding vs. cold knife tonsillectomy: a comparison of voice and speech.

OBJECTIVE: To compare acoustic, aerodynamic and perceptual voice and speech parameters in thermal welding system tonsillectomy and cold knife tonsillectomy patients in order to determine the impact of operation technique on voice and speech. METHODS: Thirty tonsillectomy patients (22 children, 8 adults) participated in this study. The preferred technique was cold knife tonsillectomy in 15 patients and thermal welding system tonsillectomy in the remaining 15 patients. One week before and 1 month after surgery the following parameters were estimated: average of fundamental frequency, Jitter, Shimmer, harmonic to noise ratio, formant frequency analyses of sustained vowels. Perceptual speech analysis and aerodynamic measurements (maximum phonation time and s/z ratio) were also conducted. RESULTS: There was no significant difference in any of the parameters between cold knife tonsillectomy and thermal welding system tonsillectomy groups (p>0.05). When the groups were contrasted among themselves with regards to preoperative and postoperative rates, fundamental frequency was found to be significantly decreased after tonsillectomy in both of the groups (p<0.001). First formant for the vowel /a/ in the cold knife tonsillectomy group and for the vowel /i/ in the thermal welding system tonsillectomy group, second formant for the vowel /u/ in the thermal welding system tonsillectomy group and third formant for the vowel /u/ in the cold knife tonsillectomy group were found to be significantly decreased (p<0.05). CONCLUSIONS: The surgical technique, whether it is cold knife or thermal welding system, does not appear to affect voice and speech in tonsillectomy patients.

Erosive esophagitis worsens reflux signs and symptoms in asthma patients without affecting pulmonary function tests.

OBJECTIVES: To determine whether erosive esophagitis (EO) worsens reflux signs and symptoms and affects pulmonary function test in asthma patients. METHODS: Sixty asthma patients with gastroesophageal and laryngopharyngeal reflux symptoms were included. Spirometry, reversibility test, esophagogastroscopy, laryngoscopy, and esophagogastroscopic biopsies were conducted. RESULTS: EO was diagnosed in 25% (n = 15) of the patients. The remaining 45 patients were placed into the non-erosive esophagitis (NEO) group. Of the 15 EO patients, grade 1 esophagitis was identified in 75% (n = 9), grade 2 in 12.5% (n = 3), and grade 3 in 12.5% (n = 3). Pulmonary function test results were not significantly different between the EO and NEO groups. Gastroesophageal and laryngopharyngeal reflux symptoms such as regurgitation, dysphagia, dyspnea, globus sensation, dysphonia, and sore throat were more frequent in EO patients than in the NEO group. The reflux finding score (RFS) was 7.33 and 4.55 in EO and NEO patients, respectively (p < .001). Posterior commissure hypertrophy was the most common laryngoscopic finding in both of the groups followed by diffuse laryngeal edema, erythema, and pseudosulcus. CONCLUSIONS: Gastroesophageal and laryngopharyngeal reflux symptoms were more frequent in EO patients than in the NEO group. The laryngoscopic findings of laryngopharyngeal reflux were more severe and the RFS was significantly higher in EO patients than in NEO patients. The presence of EO seems to be associated with an increase in reflux without affecting pulmonary function as EO did not cause a significant decrease in pulmonary function tests.