Evaluation of Vestibulo-Ocular Reflex (VOR) in Tinnitus Patients with Normal Hearing.

OBJECTIVES: This study aimed to evaluate the correlation between tinnitus parameters (duration, severity, reaction, handicap levels) and vestibulo-ocular reflex (VOR) gain values in patients with tinnitus with normal hearing without vertigo or any other complaints and to compare the VOR gains with a healthy group. MATERIALS AND METHODS: The study group consisted of 30 individuals aged between 18 and 65 years who suffered from tinnitus but not from hearing loss and vertigo. The control group also consisted of 30 individuals who were categorized as healthy adults. The tinnitus handicap inventory, tinnitus reaction questionnaire, and tinnitus handicap questionnaire were applied to each individual in the tinnitus group, and the video head impulse test (VHIT) was conducted in 2 groups. RESULTS: Statistically, a significant difference was found between the 2 groups in terms of VOR gain values in horizontal and vertical semicircular canal planes (p<0.05). However, there was no statistically significant correlation between tinnitus parameters, age, and VOR gain values in the study group (p>0.05). CONCLUSION: Considering the lower VOR gain values of the study group than the control group, these patients may need to be followed up for vestibular dysfunction associated with tinnitus, which can be a symptom of peripheral vestibular disorder. Moreover, this study will contribute to the literature because we determined a high-frequency component of VOR by VHIT, which was used to evaluate the relationship between tinnitus parameters and peripheral vestibular function.

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.

[Investigation of congenital CMV infection with the presence of CMV DNA in saliva samples of new born babies]. / Yenidogan bebeklerin tükürük örneginde CMV DNA varligi ile konjenital CMV enfeksiyonunun arastirilmasi.

Cytomegalovirus (CMV), is the most common cause among congenital infections and is the most seen etiology in long-term sensorineural hearing loss (SNHL) and neurological impairment. Congenital CMV infection (CCMV) was reported in 0.15-2.2% of live-borne neonates in studies from different countries. A significant proportion of infected infants are asymptomatic after birth and might only be detected by routine screening methods during the new born period. The aim of this study was to screen the saliva of live-born neonates with areal-time PCR based method for the detection of CCMV in our hospital. Saliva samples collected in half an hour after birth by dry dacron swabs and were evaluated for CMV DNA (Rt-PCR, Abbott Molecular USA) from 1000 babies born in Ege University Faculty of Medicine Hospital Obstetrics Clinic between October 2015-October 2017. For the confirmation of CCMV, saliva positive newborns were evaluated with the same method for CMV DNA from their urine or blood within 21 days. All newborns were screened for sensorineural hearing tests. Subjects were 497 girls (49.7%) and 503 boys (50.3%), with a mean weight of 3116.8 g and mean of 37.61 birth week. CMV DNA was positive in the saliva of 16 newborns (1.6%). Fourteen newborns were weakly positive for CMV DNA in their saliva and were not confirmed for CCMV infection. Congenital CMV was confirmed in only two (0.2%) with the CMV DNA results in urine and/or blood samples. One of the two newborns with CCMV was symptomatic and had a neurosensorial hearing loss. The other one was asymptomatic. Saliva samples, taken immediately after birth with a noninvasive and easy method for the detection of CMV DNA is very important for diagnosis of CCMV. Positive samples should be confirmed with CMV DNA in urine or blood samples of these newborns. In this study, detection of positivity in saliva samples that were confirmed with other samples of our newborn population for CCMV was 0.2%. The specific diagnosis for CCMV in newborns with a noninvasive and easy collecting sample is important to avoid sequelae and for public health concerns.

Evaluation of the Correlation Between Turkish Voice Handicap Index-10 and Turkish Voice-Related Quality of Life Scale.

OBJECTIVE: Aim of this sudy was to evaluate the correlation between Turkish Voice Handicap Index-10 (TVHI-10) and Turkish Voice-Related Quality of Life Questionnaries (TV-RQOL) on patients with dysphonia. METHODS: Two different groups were formed with patients with dysphonia and healthy individuals between February and July 2016. After medical history and otorhinolaringologic and phoniatric examinations all the subjects completed TVHI-10 and TV-RQOL questionnaries. The correlation between scores of parameters of questionnaries were evaluated. RESULTS: Data of 104 patients (59 women, 45 men) with a mean age of 46±15 years in dysphonia group and 75 individuals (38 women, 37 men) with a mean age of 45±13.8 years in healthy group were evaluated. TVHI-10 and TV-RQOL parameters' scores were significantly higher in dysphonia group than healthy group. There were positive and significant correlations between scores of TVHI-10 and TV-RQOL parameters of all 179 individuals. There was significant positive correlation between total scores of TVHI-10 and TV-RQOL values of all individuals (r=0.949, p<0.001). CONCLUSION: There is positive significant correlation between validated Turkish versions of VHI-10 and V-RQOL questionnaries as a self-assessment measurement tools. The results of studies which use TV-RQOL can be compared with the results of the studies using TVHI-10.

The Effect of Mandibulectomy and Mandibulotomy on Cochlear Function.

Mandibulectomy and mandibulotomy procedures are performed with the oscillating saw and the acoustic energy generated during the osteotomies is transferred to the cochlea via temporomandibular joint and air conduction. The aim of this study was to assess the effect of mandibulectomy and mandibulotomy on cochlear function. This study was carried out on 15 patients who underwent at an otolaryngology department of a tertiary medical center between January 2013 and August 2015. The study was designed as a prospective study. All of the data were prospectively collected. These included demographic data, date of the surgery, type of surgery, preoperative pure-tone audiometry, preoperative and postoperative distortion product otoacoustic emission (DPOAE) measurements. Of the DPOAE measurements, there was a statistically significant difference between the signal-to-noise ratio measurement on the right ear measurement at 4 kHz (P <0.05). Additionally, there was a statistically significant correlation between the signal-to-noise ratio measurements and the side of the osteotomy (P <0.05). In conclusion, it is found that mandibulectomy and mandibulotomy procedure has a negative effect on cochlear function in the early period. The DPOAEs were diminished on the osteotomy site in day one postoperatively. Results with a longer follow-up time can yield more information on the prognosis of the cochlear damage.

[Validation and reliability of Turkish Singing Voice Handicap index]. / Özgün San Sesi Handikap Endeksi ölçeginin Türkçe versiyonunun geçerlik ve güvenirligi.

OBJECTIVES: This study aims to constitute a valid and reliable Turkish version of the original Singing Voice Handicap Index. PATIENTS AND METHODS: An authorized committee assessed the reliability and validity of the content, scope, and language of the original Singing Voice Handicap Index which underwent a back translation process. The Turkish version of the questionnaire was answered twice with a 7 to 10-day interval by two singing voice groups with or without singing voice problems. The reliability and validity analyses were performed based on these answers. RESULTS: Of a total of 123 individuals (64 females, 59 males; mean age 26.2±7.3 years), 81 were without a voice pathology and 42 were with a voice pathology. The total Cronbach's alpha coefficient was 0.917. The item-total correlations ranged between 0.51 and 0.89. The weighted kappa values of test-retest correlation values of the items were 0.82-0.91. The Cronbach's alpha values of two part of the questionnaire based on the split-half method were 0.89 and 0.84. The mean total scale scores were 21.8±18.5 and 53.6±28.9 in normal and pathology groups, respectively and there was a statistically significant difference in scores between these two groups (p=0.000). CONCLUSION: The Turkish version of the Singing Voice Handicap Index is a valid and reliable scale which can be used in the evaluation of voice problems of Turkish-speaking singing voice users.

[A presentation of a practical algorithm which can be used in the management of vocal cord nodules, polyps and intraepithelial neoplasias]. / Vokal kord nodül, polip ve intraepitelyal neoplazilerinin yönetiminde kullanilabilecek pratik bir algoritma sunumu.

OBJECTIVES: This study aims to offer an accurate diagnosis for vocal cord nodules, polyps, and intraepithelial neoplasias through videolaryngostroboscopy (VLS) and multi-dimensional voice analysis program (MDVP) and to decide management modalities. PATIENTS AND METHODS: A total of 397 patients (214 males, 183 females; mean age 46.2 years; range 17 to 71 years) with 218 nodules, 101 polyps and 78 vocal cord intraepithelial neoplasias who were admitted for treatment and follow-up in phoniatry unit of our clinic in the past five years were retrospectively analyzed in terms of VLS findings, the percent of jitter, percent of shimmer, fundamentally frequency, noise-harmonic ratio values, GRBAS [Grade of dysphonia (G), roughness (R), breathiness (B), asthenicity (A) and strain (S)] scores, and voice handicap index (VHI) obtained by MDVP. RESULTS: We obtained better voice parameters with improved GRBAS and SHE scores in patients with vocal cord nodules who underwent voice training and those with polyps who were operated, while these scores worsened following diagnostic phonosurgery in the intraepithelial group. CONCLUSION: In the initial examination, patients who are prediagnosed vocal cord nodules should have voice therapy as the first-line treatment modality and checked for the response to treatment. If laryngeal cancer is suspected, surgery should be planned according to the biopsy result and biopsy should be performed, if polyp is present.