Differences of the Voice Parameters Between the Population of Different Hearing Tresholds: Findings by Using the Multi-Dimensional Voice Program

OBJECTIVES: To compare voice parameters in subjects with different hearing level. METHODS: The evaluation consisted of Multi-Dimensional Voice Program (MDVP) and electroglottography. Group 1 consisted of normal hearing subjects which is bilateral average hearing better than 25 decibels (dB) whereas group 2 consisted of patients who have bilateral average hearing between the 25 and 60 dB and group 3 consisted of patients who have bilateral average hearing between the 60 and 90 dB. The evaluations were performed on males and females separately. RESULTS: In female subjects, fundamental frequency (F0), absolute jitter, %jitter and soft phonation index (SPI) were significantly different between the group 1 and group 2. Also, we detected significant difference on maximum phonation time (MPT), fundamental frequency, absolute jitter and %jitter, and variable F0 (vF0) values between group 1 and group 3. Male subjects demonstrated significant difference between the group 1 and group 2 in MPT, absolute jitter, %jitter, vF0, and SPI parameters. Between the group 3 and group 1; differences in absolute jitter, %jitter, shimmer, %shimmer, vF0, and SPI were also significant. CONCLUSION: This study concluded that even mild to moderate hearing losses may affect voice patterns in adults and also females and males react differently to hearing loss in some parameters.

Recurrent and Massive Life Threatening Epistaxis due to Nasal Heroin Usage

Epistaxis, active bleeding from the nose, is a common ear nose and throat emergency, and can be severe or even fatal. We report a severe life threatening recurrent massive nasal bleeding caused by intranasal heroin use that has not hitherto been reported in the English literature. A 24-year-old male who took heroin several times nasally presented with massive nasal bleeding. A blood transfusion and an operation to halt nasal bleeding were required. The patient did not experience a bleeding attack 2 months following cessation of nasal heroin use.

Evaluation and Management of Antrochoanal Polyps

Antrochoanal polyps (ACPs) are benign polypoid lesions arising from the maxillary antrum and they extend into the choana. They occur more commonly in children and young adults, and they are almost always unilateral. The etiopathogenesis of ACPs is not clear. Nasal obstruction and nasal drainage are the most common presenting symptoms. The differential diagnosis should include the causes of unilateral nasal obstruction. Nasal endoscopy and computed tomography scans are the main diagnostic techniques, and the treatment of ACPs is always surgical. Functional endoscopic sinus surgery (FESS) and powered instrumentation during FESS for complete removal of ACPs are extremely safe and effective procedures. Physicians should focus on detecting the exact origin and extent of the polyp to prevent recurrence.