Evaluation of Voice Quality in Patients With Vocal Fold Polyps: The Size of a Polyp Matters or Does it?

OBJECTIVE: This study aimed to investigate the correlation between morphological features of vocal fold polyps (VFPs) and subjective/objective voice parameters. METHODS: Perceptual evaluations, aerodynamic and acoustic tests were performed on 47 patients with VFPs. Still images were captured from video and the morphological features associated with the size of VFP were quantified. To reveal the correlation between size-related morphological features (length of polyp base, the ratio of polyp base to vocal fold length, glottal gap area) and objective/subjective parameters of voice, Pearson's and Spearman's tests were carried out. RESULTS: This cohort was composed of 30 (63.8 %) male and 17 (36.2%) female patients with the mean age of 45.2 years and 41.3 years, respectively. No correlation was found between the morphological features of VFPs and any of perceptual, aerodynamic and acoustic voice parameters. CONCLUSIONS: Our findings indicated that controversies still exist regarding the role of vocal fold polyp morphology in clinical decision making.

Utilizing Infant Cry Acoustics to Determine Gestational Age.

OBJECTIVES/HYPOTHESIS: The date of last menstruation period and ultrasonography are the most commonly used methods to determine gestational age (GA). However, if these data are not clear, some scoring systems performed after birth can be used. New Ballard Score (NBS) is a commonly used method in estimation of GA. Cry sound may reflect the developmental integrity of the infant. The aim of this study was to evaluate the connection between the infants' GA and some acoustic parameters of the infant cry. STUDY DESIGN: A prospective single-blind study was carried out. METHODS: In this prospective study, medically stable infants without any congenital craniofacial anomalies were evaluated. During routine blood sampling, cry sounds were recorded and acoustic analysis was performed. Step-by-step multiple linear regression analysis was performed. RESULTS: The data of 116 infants (57 female, 59 male) with the known GA (34.6 ± 3.8 weeks) were evaluated and with Apgar score of higher than 5. The real GA was significantly and well correlated with the estimated GA according to the NBS, F0, Int, Jitt, and latency parameters. The obtained stepwise linear regression analysis model was formulized as GA=(31.169) - (0.020 × F0)+(0.286 × GA according to NBS) - (0.003 × Latency)+(0.108 × Int) - (0.367 × Jitt). The real GA could be determined with a ratio of 91.7% using this model. CONCLUSIONS: We have determined that after addition of F0, Int, Jitt, and latency to NBS, the power of GA estimation would be increased. This simple formula can be used to determine GA in clinical practice but validity of such prediction formulas needs to be further tested.

Normative Values of Voice Analysis Parameters With Respect to Menstrual Cycle in Healthy Adult Turkish Women.

OBJECTIVE/HYPOTHESIS: Objective measurements are quite important for assessment of voice disorders. The first aim of this study was to establish a prototype database of normative values of voice analysis parameters in healthy Turkish adult female population. The second aim was to evaluate the variations of these parameters during physiological menstrual cycle. STUDY DESIGN: This is a prospective, single-blind study. METHODS: Eighty-nine healthy women (mean age, 31.5 ± 6.0 years) with normal physical findings and without vocal abuse or dysphonia were participated. Detailed physical and videostroboscopic larynx examination was done. Participants' voice samples of sustained /a/ and /i/ vowels were recorded, and voice analysis was done. GRBAS scale was done by four otolaryngologists, and subjects were asked to score their own voice quality using Voice Handicap Index-10 (VHI-10) at the premenstruation, during menstruation, and postmenstruation periods. RESULTS: Eighty-nine healthy Turkish women's some normative acoustic vocal parameters of three different phases of menstrual cycle were reported. The data indicated that during the premenstruation period; the mean jitter %, shimmer % and noise-to-harmonic ratio values were significantly higher than that of other two periods. Variations of computerized acoustic vocal analysis parameters through menstruation cycle were in concordance with the perceptual voice assessment (GRBAS) and the questionnaire of subjects' perception of their own voices (VHI-10). CONCLUSIONS: In this study the normative values of voice analysis parameters of healthy adult Turkish women was reported. Adding computerized voice analysis parameters may improve the assessment and screening of voice in routine clinical practice because this is a simple and reliable method. Evaluation of voice can be performed regardless of the phases of menstrual cycle, but not performing acoustic analysis during the premenstrual period may prevent some of the unintended errors.

Investigation of surface changes in different types of ventilation tubes using scanning electron microscopy and correlation of findings with clinical follow-up.

OBJECTIVES: Like all biomaterials, ventilation tubes are subject to formation of bacterial biofilm on their surfaces. There might also be surface changes. This increases the risk of complications associated with ventilation tubes. In this study, we examined two groups of ventilation tubes using scanning electron microscopy (SEM) to investigate biofilm growth and surface deformations. METHODS: There were two different types of ventilation tubes used, the first group consisted of 30 silicone tubes and the second group consisted of 16 ionized, processed silicone tubes. The tube samples included those that were either removed or those that were extruded into the ear canal. We investigated the association between scanning electron microscopy findings and the complications that developed during the treatment. RESULTS: As a result of this study, it is found that the ionized, processed silicone tubes are superior to other silicon ventilation tubes in regard to biofilm growth (z=-3.925, p=0.000, <0.0001) and surface deformations (chi(2)=9.120, p=0.003, <0.01). Furthermore, we observed that as the duration of the ventilation tube application increases, bacterial biofilm growth (chi(2)=10.718, p=0.005, <0.01) and surface deformations (z=-2.940, p=0.003, <0.01) increase. We also observed that biofilm growth and occurrence frequency were related to "otorrhea" (chi(2)=10.258, p=0.036, <0.05) and "plugging" (chi(2)=7.952, p=0.019, <0.05) complications. CONCLUSION: In this study, we show that ionized, processed silicone ventilation tubes are more robust to bacterial biofilm growth compared to other silicone ventilation tubes used in this study and that the "otorrhea" and "plugging" complications are reduced with the decrease of bacterial biofilm growth.