Glottal Voice Distortions: Nasolaryngoscopic and Spectral Analysis of Anatomophysiologic Changes in Singing Voice

xlomafota13 shared this article with you from Inoreader Glottal Voice Distortions: Nasolaryngoscopic and Spectral Analysis of Anatomophysiologic Changes in Singing Voice Via Journal of Voice The distorted voices, commonly called vocal drives in Brazil and in some other South American countries, are vocal ornaments belonging to the aesthetics of popular singing and desired by singers of different styles. The advances in vocal sciences have allowed the demystification of this type of technique in the last four decades, classifying them as glottal, supraglottic or mixed distortions/drives. The interdisciplinary approach in the evaluation of singers who use glottal distortions is fundamental for a broad understanding of the particularities of each case. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Twelve years of neonatal hearing screening: audiological and etiological results

xlomafota13 shared this article with you from Inoreader Twelve years of neonatal hearing screening: audiological and etiological results Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Aug 31. doi: 10.1007/s00405-021-07060-5. Online ahead of print. ABSTRACT PURPOSE: Most developed countries have implemented some form of universal newborn hearing screening program. Early identification and rehabilitation of congenital hearing loss is important in functional outcome, and the need to identify the cause of hearing impairment has become clear. We aimed to evaluate audiological and etiological outcomes in a large group of patients with failed neonatal hearing screening. METHODS: We performed a retrospective chart analysis of patients who were referred to our tertiary referral center after failing neonatal hearing screening during a 12-year period (2007-2019). Screening was based on automated auditory brainstem response (AABR) or a combined approach of AABR and auditory steady-state response (ASSR) with chirp stimulus. Extensive audiometric testing was performed to confirm and determine the type and degree of hearing loss. In case of permanent hearing loss, a standardized etiological protocol was followed to determine the cause. RESULTS: Of the 802 referred newborns, hearing loss was confirmed by diagnostic ABR in 78%. Main causes of hearing loss included otitis media with effusion (56%, higher in patients screened by AABR/ASSR compared to AABR), a genetic disorder (12%), congenital cytomegalovirus infection (cCMV, 5%) and atresia/stenosis of the external ear canal (5%). Of the patients with permanent hearing loss, 15% showed changes in hearing loss severity over time. CONCLUSION: In the majority of newborns referred after failing universal neonatal hearing screening, hearing loss could be confirmed. The leading cause was reversible hearing loss due to otitis media with effusion, but hearing loss proved permanent in about 35% of referred newborns, with genetics as predominant cause. Follow-up of congenital hearing loss patients is important as deterior ation as well as improvement was observed over time. PMID:34463816 | DOI:10.1007/s00405-021-07060-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Characteristics of Older Adults Seeking Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea

xlomafota13 shared this article with you from Inoreader Clinical Characteristics of Older Adults Seeking Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea Via ear nose throat Ear Nose Throat J. 2021 Aug 31:1455613211042126. doi: 10.1177/01455613211042126. Online ahead of print. ABSTRACT OBJECTIVES: Obstructive sleep apnea (OSA) is a common sleep disorder with numerous clinical correlates. Although effective treatments abound, patient acceptance and adherence is low. Hypoglossal nerve stimulation (HNS) is a surgical treatment alternative for the treatment of OSA; however, the demographic and clinical characteristics of individuals seeking HNS are not well categorized. This study sought to determine the clinical characteristics of older adults seeking HNS for the treatment of OSA. METHODS: Self-report questionnaires were administered to all patients older than 50 years seeking a HNS consultation at a large university medical center. Questionnaires included validated National Institutes of Health Patient-Reported Outcomes Measurement Information System (NIH PROMIS) measures of physical functioning, sleep-related impairment, cognitive abilities, depression, anxiety, and anger along with the Information extracted from electronic medical records included age, sex, race, and apnea-hypopnea index (AHI). RESULTS: Patients included 113 adults (mean age 63.30 years, 57% male, 79% white) with severe OSA (AHI = 33.91, standard deviation = 20.63). Overall, 88% of patients reported elevated insomnia symptoms, 30% reported mild difficulty with physical functioning, and 36% indicated that they had experienced moderate-severe day time impairments attributed to poor sleep. Additionally, we found 28% of sampled individuals reported moderate-severe depressive symptomology, over 19% reported moderate-severe anxiety, and over 17% reported moderate to severe anger issues. Approximately, 38% of the sample reported moderate to severe cognitive difficulties. CONCLUSIONS: The aim of the study was to better understand the clinical characteristics of older patients with OSA seeking HNS treatment. Utilizing NIH PROMIS questionnaires, we identified unique clinical and psychosocial correlates in this sample, which included higher rates of insomnia symptoms, physical dysfunction, cognitive deficits, and depressive symptoms than the general population. Future studies will be needed to investigate these relationships more thoroughly and throughout the course of the treatment. PMID:34464165 | DOI:10.1177/01455613211042126 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Treatment of Postinfectious Olfactory Dysfunction Using Corticosteroids

xlomafota13 shared this article with you from Inoreader Treatment of Postinfectious Olfactory Dysfunction Using Corticosteroids Via ear nose throat Ear Nose Throat J. 2021 Aug 31:1455613211040368. doi: 10.1177/01455613211040368. Online ahead of print. ABSTRACT OBJECTIVE: This study aimed to analyze the efficacy of different doses and forms of corticosteroids in the treatment of postinfectious olfactory dysfunction and to specify the factors related to the curative effects. METHODS: The medical records of patients diagnosed with postinfectious olfactory dysfunction from January 2018 to May 2019 were reviewed. All p atients received different doses of oral corticosteroids for 12 days or inhaled corticosteroids for 1 month. RESULTS: A review of the records of 43 patients showed that the mean follow-up time was 6.66 months, and the overall effective rate of treatment was 48.8%. Postinfectious olfactory dysfunction exhibited distinct seasonality, with the highest incidence in March. The curative effect was significantly related to the olfactory discrimination threshold at the first consultation (P = .022), but not significantly associated with age (P = .325), sex (P = .924), duration of disease (P = .526), follow-up time (P = .489), or treatment program (P = .330). CONCLUSIONS: Different doses and forms of corticosteroids showed no significant difference in the therapeutic effect on postinfectious olfactory dysfunction. The olfactory discrimination threshold at the first consultation was the most important factor influencing the prognosis. < p>PMID:34464164 | DOI:10.1177/01455613211040368 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Optimized fitting of a midface implant to anchor a magnetic nasal prosthesis using 3D printing

xlomafota13 shared this article with you from Inoreader Optimized fitting of a midface implant to anchor a magnetic nasal prosthesis using 3D printing Via hno HNO. 2021 Aug 31. doi: 10.1007/s00106-021-01100-6. Online ahead of print. ABSTRACT BACKGROUND: Plate-based anchorage systems for craniofacial prostheses offer advantages over extraoral solitary titanium implants in terms of the flexible choice of mounting points and higher stability. Disadvantages become apparent in the complex individual intraoperative adaptation of the plate-based systems to the usually poorly accessible bone. The current article presents a method to overc ome these disadvantages and make greater use of the advantages of plate-based systems. MATERIALS AND METHODS: The bony midface of a patient who had undergone rhinectomy for cancer of the nasal entrance was reconstructed as a virtual 3D model based on preoperative CT. The open-source software (3D-Slicer) allowed easy and fast reconstruction as well as adaptation for 3D printing using transparent plastic (MED610; stratasys Ltd., MN, USA). RESULTS: A titanium mini-plate (MEDICON) for anchoring the nasal prosthesis could be fitted extremely precisely on the midface 3D print. Important anatomical structures were spared, and screw placement was selected according to the individual bone thickness. Implantation of the in-advance fitted titanium plate was performed without complications and without further adjustments. CONCLUSION: In-advance fitting of plate-based systems for anchorage of craniofacial prostheses using 3D printing of the midface overcomes their disadvantages of time-consuming and possibly imprecise individual adaptation. This method further exploits the advantages of higher stability through more possible mounting points, even in thinner bone, to prevent loosening. In addition, in-advance fitting of titanium plates on the 3D model enables better identification and protection of important anatomical structures and shortens operative time. PMID:34463790 | DOI:10.1007/s00106-021-01100-6 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acoustic Change Complex and Visually Reinforced Infant Speech Discrimination Measures of Vowel Contrast Detection

xlomafota13 shared this article with you from Inoreader Acoustic Change Complex and Visually Reinforced Infant Speech Discrimination Measures of Vowel Contrast Detection Via cortical auditory Ear Hear. 2021 Aug 25. doi: 10.1097/AUD.0000000000001116. Online ahead of print. ABSTRACT OBJECTIVES: To measure the effect of stimulus rate and vowel change direction on the acoustic change complex (ACC) latencies and amplitudes and compare ACC metrics to behavioral measures of vowel contrast detection for infants tested under the age of 1 year. We tested the hypothesis that the direction of spectral energy shift from a vowel change would result in differences in the ACC, owing to the sensitivity of cortical neurons to the direction of frequency change. We evaluated the effect of the stimulus rate (1/s versus 2/s) on the infants' ACC. We evaluated the ACC amplitude ratio's sensitivity (proportion of ACCs present for each change trial) and compared it to perceptual responses obtained using a visually reinforced infant speech discrimination paradigm (VRISD). This report provides normative data from infants for the ACC toward the ultimate goal of developing a clinically useful index of neural capacity for vowel discrimination. DESIGN: Twenty-nine infants, nine females, 4.0 to 11.8 months of age, participated. All participants were born at full term and passed their newborn hearing screens. None had risk factors for hearing or neurologic impairment. Cortical auditory evoked potentials were obtained in response to synthesized vowel tokens /a/, /i/, /o/, and /u/ presented at a rate of 1- or 2/s in an oddball stimulus paradigm with a 25% probability of the deviant stimulus. All combinations of vowel tokens were tested at the two rates. The ACC was obtained in response to the deviant stimulus. The infants were also tested for vowel contrast detection using a VRISD paradigm with the same combinations of vowel tokens used for the ACC. The mean age at the time of the ACC test was 5.4 months, while the mean age at the behavioral test was 6.8 months. RESULTS: Variations in ACC amplitude and latency occurred as a functio n of the initial vowel token and the contrast token. However, the hypothesis that the direction of vowel (spectral) change would result in significantly larger change responses for high-to-low spectral changes was not supported. The contrasts with /a/ as the leading vowel of the contrast pair resulted in the largest ACC amplitudes than other conditions. Significant differences in the ACC presence and amplitude were observed as a function of rate, with 2/s resulting in ACCs with the largest amplitude ratios. Latency effects of vowel contrast and rate were present, but not systematic. The ACC amplitude ratio's sensitivity for detecting a vowel contrast was greater for the 2/s rate than the 1/s rate. For an amplitude ratio criterion of ≥1.5, the sensitivity was 93% for ACC component P2-N2 at 2/s, whereas at 1/s sensitivity was 70%. VRISD tests of vowel-contrast detection had a 71% hit and a 21% false-positive rate. Many infants who could not reach performance criteria for VRISD had A CC amplitude ratios of ≥2.0. CONCLUSIONS: The ACC for vowel contrasts presented at a rate of 2/s is a robust index of vowel-contrast detection when obtained in typically developing infants under the age of 1 year. The ACC is present in over 90% of infants tested at this rate when an amplitude ratio criterion of ≥1.5 is used to define a response. The amplitude ratio appears to be a sensitive metric for the difference between a control and contrast condition. The ACC can be obtained in infants who do not yet exhibit valid behavioral responses for vowel change contrasts and may be useful for estimating neural capacity for discriminating these sounds. PMID:34456301 | DOI:10.1097/AUD.0000000000001116 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correlations of Radiographic and Endoscopic Observations in Subglottic Stenosis

xlomafota13 shared this article with you from Inoreader Correlations of Radiographic and Endoscopic Observations in Subglottic Stenosis Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Aug 28:34894211042768. doi: 10.1177/00034894211042768. Online ahead of print. ABSTRACT OBJECTIVE(S): Subglottic stenosis (SGS) represents a constellation of diverse pathologic processes that ultimately lead to narrowing of the subglottic region and can produce significant morbidity. Existing endoscopic and radiographic assessments may not be consistent in practice. METHODS: Severity of stenosis was evaluated and reported using the Cotton-M yer classification system from 33 endoscopic procedures from 32 unique subjects. Radiographic imaging within the preceding 3 month period was subsequently reviewed and narrowing was measured by a blinded radiologist. Degree of stenosis was reported as a percentage in 30 out of 33 endoscopic evaluations and subsequently compared to radiographically determined percentage of stenosis. Statistical analyzes were conducted to evaluate concordance between endoscopic and radiographic assessments. RESULTS: About 45.5% (15/33) of the evaluations were in agreement using Cotton-Myer scoring, while 27.3% (9/33) were discrepant by 1 grade and 27.3% (9/33) by 2 grades. Correlation of degree of stenosis as a percentage using Spearman (coefficient: 0.233, P-value: .214) and Pearson (coefficient: 0.138, P-value: .466) methods demonstrated very weak relationships. Radiographic scoring did not predict endoscopic classification to a significant degree using mixed effects regression.< /p> CONCLUSIONS: Radiographic and endoscopic grading of subglottic stenosis may not be reliably concordant in practice. PMID:34459264 | DOI:10.1177/00034894211042768 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.