Acoustic and perceptual voice parameters in subclinical and overt primary hypothyroidism.

OBJECTIVE: Hypothyroidism is a common endocrine disorder affecting various systems of the body. Only a few studies have focused on the effect of primary hypothyroidism on voice with objective parameters, and none of them compared the effect of subclinical and overt hypothyroidism on voice. The aim of the present study is to evaluate and compare the acoustic and perceptual parameters of voice in patients newly diagnosed with subclinical and overt hypothyroidism. METHODS: The study included 26 subclinical hypothyroidism, 26 overt hypothyroidism patients and 30 euthyroid control participants. Perceptual evaluation of voice with GRBAS (grade, roughness, breathiness, asthenia, strain) scale, voice handicap index (VHI)-10, and acoustic voice analysis by using Multi-Dimensional Voice Program were performed for all the participants. RESULTS: The voice parameters which showed a statistically significant difference between the groups were frequency parameters (Fo; p= 0.003, Fhi; p=0.010, Flo; p= 0.002) and VHI-10 (p= 0.047). A statistically significant decrease in frequency parameters and a statistically significant increase in VHI-10 were found in overt hypothyroidism group comparing with control group (Fo; p= 0.002, Fhi; p=0.009, Flo; p= 0.001 and VHI-10; p= 0.046). Voice parameters in subclinical hypothyroidism group did not show a statistically significant difference comparing with both control and overt hypothyroidism groups. CONCLUSION: In the present study, overt hypothyroidism is found to affect frequency parameters and patients' own subjective assessment of voice. Primary hypothyroidism does not seem to have significant effect on voice parameters until thyroxine levels are affected.

The assessment of presenteeism and activity impairment in Behçet's syndrome and recurrent aphthous stomatitis: a multicentre study.

OBJECTIVE: To evaluate key factors for presenteeism and activity impairment in multinational patients with Behçet's syndrome (BS) and recurrent aphthous stomatitis (RAS). METHODS: In this cross-sectional study, 364 BS patients from Jordan, Brazil, the United Kingdom and Turkey and 143 RAS patients from the United Kingdom and Turkey were included. The Work Productivity Activity Impairment (WPAI) scale was used for presenteeism and activity impairment. Mediation analyses were performed to evaluate both direct and indirect causal effects. RESULTS: Presenteeism score was higher in active patients with genital ulcers and eye involvement as well as patients with comorbidities and current smokers than the others in BS (P < 0.05). In RAS, presenteeism score was elevated by oral ulcer activity in the direct path (P = 0.0073) and long disease duration as a mediator in the indirect path (P = 0.0191). Patients with active joint involvement had poor scores in absenteeism, presenteeism, overall impairment and activity impairment compared with those of inactive patients (P < 0.05). Using mediation analysis, the activity impairment score was directly mediated by joint activity (P = 0.0001) and indirectly mediated through oral ulcer-related pain in BS (P = 0.0309). CONCLUSION: In BS, presenteeism was associated with disease activity, presence of comorbidities and being a current smoker, whereas in RAS, presenteeism was associated with oral ulcer activity and increased length of the disease. Moreover, activity impairment was adversely affected by joint activity and oral ulcer related pain in BS. Patients need to be empowered by using appropriate treatment strategies in their working environment and daily life.

Do otosclerosis and stapedotomy affect semicircular canal functions? Preliminary results of video head impulse test.

BACKGROUND: Otosclerosis and stapedotomy have some effects on the vestibular system, but there are very limited data on their effects on semicircular canals (SCCs). OBJECTIVE: The aim of the study is to investigate if otosclerosis and stapedotomy have an effect on SCCs and video head impulse test (vHIT). MATERIAL AND METHODS: This retrospective study included 11 otosclerosis patients who had undergone stapedotomy and 30 healthy participants. Twenty-two ears of 11 patients with otosclerosis were divided into two groups based on whether the ear had been operated (12 ears) or not (10 ears). All participants underwent vHIT. We compared gains of all SCCs, presence of saccades among the operated ears, unoperated ears and control ears. RESULTS: Significant difference (p<.05) was noted in comparisons of gain of lateral SCCs among all groups. Control group had the highest gain, followed by unoperated and operated groups, respectively. Comparison of incidence of covert saccade showed significant difference (p<.05) for lateral and posterior SCCs. CONCLUSIONS AND SIGNIFICANCE: Otosclerosis and otosclerosis surgery may have some effects on SCC functions and thereby vHIT. Lateral SCC is the most affected SCC in terms of gain. These findings appear to add important contributions to our knowledge.

Can Narrow Band Chirp Stimulus Shake the Throne of 500 Hz Tone Burst Stimulus for Cervical Vestibular Myogenic Potentials?

BACKGROUND AND OBJECTIVES: The aim of the study was to compare effects of tone-burst (TB) and narrow-band (NB) Claus Elberling (CE)-chirp stimuli on amplitude, latency and interaural asymmetry ratio (IAR) of cervical vestibular evoked myogenic potentials (cVEMP) in healthy individuals. SUBJECTS AND METHODS: The study included 50 healthy volunteers. cVEMP procedure was carried out using 500 Hz TB and NB-CE-chirp stimulus (360-720 Hz, up-chirp) in random order. cVEMP were recorded at 100 dB nHL. For each ear and each stimulus, P1 latency, N1 latency and P1N1 amplitude were measured. IAR was also calculated. RESULTS: Mean age was 26.66±9.48 years. cVEMP's in response to both TB and NB CE-chirp stimuli were obtained in all subjects. No statistically significant difference in P1 latency, N1 latency, and P1N1 amplitude was found between the right and left ears for both TB and NB CE-chirp stimuli (p>0.05). In both sides, P1 and N1 latencies were significantly shorter in NB CE-chirp stimulation compared to TB stimulation (p=0.000). In both sides, no statistically significant difference was found in P1N1 amplitude between two types of stimuli (p>0.05). CONCLUSIONS: The chirp stimulus produces robust but earlier cVEMP than TB does. This largest series study on NB chirp cVEMP shows that NB chirp is a good and new reliable alternative.

Differences in bone conduction ocular vestibular evoked myogenic potentials to 500 Hz narrow band chirp stimulus and 500 Hz tone burst.

OBJECTIVE: This study aims to investigate the differences of N1 latency, P1 latency and N1P1 amplitude in response to bone conducted 500 Hz tone burst and narrowband CE chirp stimulus in ocular vestibular evoked myogenic potentials (oVEMPs). METHODS: Forty-two healthy volunteers were included in this prospective study. Subjects with abnormal otological examinations and otological diseases were excluded. oVEMPs were randomly recorded in response to BC 500 Hz narrowband (NB) chirp stimulus and BC 500 Hz tone burst. The stimulus intensity was 50 dB nHL for both 500 Hz tone burst and 500 Hz NB CE chirp stimulus. P1 latency, N1 latency, and N1P1 amplitude were measured, and these measurements were compared between these two types of stimuli. RESULTS: Both types of stimuli elicited oVEMP in all subjects. N1 latency and P1 latency were significantly shorter (6.41 ms vs 10.84 ms; 10.64 ms vs 15.56 ms, respectively) for chirp stimulus (p < 0.05). N1P1 amplitude was significantly higher (11.64 vs 7.18 µV) for NB chirp stimulus (p < 0.05). CONCLUSION: It is reasonable to conclude that the NB CE chirp stimulus is effective to elicit robust BC oVEMP in healthy subjects.

Routine Vestibular Tests May Point Out Vestibular Subtype of Seasickness Only.

BACKGROUND: The vestibular system is important in the pathogenesis of seasickness. Our objective is to investigate whether routine vestibular tests detect seasickness.METHODS: Included were 17 professional naval personnel (mean age of 29.76 4.73 yr) diagnosed as having seasickness and 29 healthy age- and gender-matched controls. Cervical (c) vestibular evoked myogenic potentials (VEMP) and ocular (o) VEMP and bithermal caloric tests were performed after ear, nose, and throat examination, pure tone audiometry, and magnetic resonance imaging. Severity of seasickness was evaluated based on the Graybiel scale. P1 latency, N1 latency, P1N1 amplitude, and interaural asymmetry ratios (IAR) of cVEMP and oVEMP were compared between the patients and control groups. Abnormal findings in the caloric test were noted. Presence of an abnormality in any of the three vestibular tests (cVEMP, oVEMP, or caloric test) was accepted as a positive vestibular finding.RESULTS: According to the Graybiel Scale, severe malaise and frank sickness were observed in 3 patients (18.7%) and 13 patients (81.3%), respectively. Graybiel scoring could not be performed in one patient due to general discomfort and bad general condition. In the caloric test, each of three patients (17.65%) showed canal paresis, an incomplete test because of severe nausea, and vomiting and hyperactive response. There were no significant differences in P1 latency, N1 latency, P1N1 amplitude, or IAR of cVEMP and oVEMP (P > 0.05). There were three patients (17.65%) and two patients (11.76%) who had abnormal IAR for cVEMP and oVEMP, respectively.CONCLUSION: Routine vestibular tests may detect some findings in only a minority of patients with seasickness.Satar B, Akin Ocal FC, Karacayli C, Coban VK. Routine vestibular tests may point out vestibular subtype of seasickness only. Aerosp Med Hum Perform. 2020; 91(11):852860.

Normative Data of Ocular Vestibular Evoked Myogenic Potentials in Response to Chirp Stimulus.

OBJECTIVES: This study aims at comparing the tone-burst (TB) and narrow-band (NB) CE-chirp stimuli in terms of amplitude, latency, and interaural asymmetry ratio (IAR) in ocular vestibular evoked myogenic potentials (oVEMP). MATERIALS AND METHODS: In this prospective study, we enrolled 60 healthy subjects (27 men, 33 women) with a mean age of 25.83 (range, 18-48) years. Otological examination was normal in all the subjects. The subjects did not have any otological disease. All the subjects underwent oVEMP testing. We used 500 Hz TB stimulus and 500 Hz NB CE-chirp stimulus in random order. oVEMP test was performed at 100 dB normalized hearing level. P1 latency, N1 latency, and P1N1 amplitude were measured for each ear and stimulus, and IAR was calculated. RESULTS: Ocular VEMPs were obtained from all the subjects for both the stimuli. P1 and N1 latencies were significantly shorter in chirp stimulus than in TB stimulus for both the sides (p<0.0001). P1 and N1 amplitudes were significantly higher for chirp stimulus than for TB stimulus for both the sides (p<0.0001). There was no significant difference between the ears in IAR between the 2 types of stimuli. CONCLUSION: Narrow-band CE-chirp stimulus is an effective stimulus to evoke oVEMP with higher amplitudes and shortened latencies.

Blood parameters as indicators of upper airway obstruction in children with adenoid or adenotonsillar hypertrophy.

UNLABELLED: Adenotonsillar hypertrophy (ATH) is the most common cause of obstructive sleep apnea in children. This study aimed to evaluate the blood parameters of children with ATH who underwent surgery. METHODS: The study included a review of the medical records of 130 children who underwent adenoidectomy or adenotonsillectomy with a diagnosis of adenoid hypertrophy and/or chronic tonsillitis. Patients were classified into 3 groups: group 1 (n=69) underwent adenoidectomy, group 2 (n=61) underwent adenotonsillectomy, and group 3 consisted of 82 healthy children. White blood cell count, platelet count, hemoglobin levels, mean platelet volume, and platelet distribution width values were the primary outcome measures. RESULTS: Mean platelet volume, platelet distribution width and hemoglobin values decreased in the groups that underwent surgery. Whereas the decrease in group 1 was insignificant, it was significant in group 2. White blood cell count values increased in both group 1 (adenoidectomy) and group 2 (adenotonsillectomy), but the increase in group 2 was significant. No significant difference in platelet count was detected before versus after the operation. CONCLUSIONS: Upper airway obstruction caused by ATH remarkably changes the blood parameters related to chronic hypoxia. Significant improvement can be achieved after adenotonsillectomy rather than adenoidectomy alone.