The Comparison of Cepstral Peak Prominence by Using Speech Tool and Praat for Voice Analysis of Patients With Vocal Cord Palsy

Background and Objectives@#This study aimed to evaluate the voice of patients with vocal cord palsy using the Praat compared to Speech tool.Materials and Method The medical record of the patients with vocal cord palsy from 2013 to 2021 was analyzed retrospectively to validate Praat as a voice evaluation modality compared to the speech tool. Total 60 patients were enrolled in this study. Thirty control and 30 vocal cord palsy patients were selected to undergo recording of voice samples. The voice samples, /a/ and “Sancheck” were evaluated both groups and cepstral peak prominence was analyzed with both modalities; Praat and speech tool. @*Results@#Statistically significant differences were observed between the control and vocal cord palsy groups in the speech tool and Praat. There was also a significant difference between pre- and post-treatment values in the vocal cord palsy group. A similar change in the voice value was observed using both methods. The Praat showed a lower value in 1st visit of patients with vocal cord palsy in the vowel test. The Praat vowel test may sensitively represent voice problems in patients with vocal cord palsy. This could contribute to decision-making regarding the treatment modality for vocal cord palsy. @*Conclusion@#Praat is open-access software that is freely available. It can be easily and sufficiently used for voice evaluation in patients with vocal cord palsy.

Sentinel Lymph Node Biopsy Versus Elective Neck Dissection: Long-Term Oncologic Outcomes in Clinically Node-Negative Tongue Cancer

Objectives@#. The aim of this study was to compare the long-term oncologic outcomes of sentinel lymph node biopsy (SLNB) versus elective neck dissection (END) in clinically node-negative (cN0) tongue cancer. @*Methods@#. This was a retrospective cohort study of patients with cN0 tongue cancer from a single institution, including 91 patients in the SLNB group and 120 patients in the END group. @*Results@#. The overall recurrence rate showed no significant difference between the two groups. The regional control rate was also comparable between the two groups (P=0.490). The 5-year recurrence-free survival (RFS) was slightly better in the SLNB group than in the END group (P=0.427). The 5-year overall survival (OS) rate was 89.9% in the SLNB group versus 91.9% in the END group (P=0.737). In a propensity-matched subgroup analysis, the type of neck management did not affect RFS or OS. @*Conclusion@#. SLNB showed non-inferior oncologic outcomes compared to END in patients with cN0 tongue squamous cell carcinoma.

Two Cases of Recurrent Nasopharyngeal Stricture Treated with Nasoseptal Flap / 대한이비인후과학회지

The treatment of total or near-total nasopharyngeal stenosis is challenging because of frequent restenosis. Many treatment strategies including scar release with CO₂ laser, mitomycin C application, balloon dilatation or nasopharyngeal stent had been proposed to reduce the restenosis of nasopharynx. But nasopharyngeal patency often fail even after multiple surgical trials. We report two successful cases of nasopharyngeal reconstruction with resurfacing by nasoseptal flap for patients with restenosis history.

Two Cases of Recurrent Nasopharyngeal Stricture Treated with Nasoseptal Flap / 대한이비인후과학회지

The treatment of total or near-total nasopharyngeal stenosis is challenging because of frequent restenosis. Many treatment strategies including scar release with COâ‚‚ laser, mitomycin C application, balloon dilatation or nasopharyngeal stent had been proposed to reduce the restenosis of nasopharynx. But nasopharyngeal patency often fail even after multiple surgical trials. We report two successful cases of nasopharyngeal reconstruction with resurfacing by nasoseptal flap for patients with restenosis history.

Comparison of Endoscopic Tympanoplasty to Microscopic Tympanoplasty

OBJECTIVES: This study aimed to compare the outcome of endoscopic and microscopic tympanoplasty. METHODS: This was a retrospective comparative study of 73 patients (35 males and 38 females) who underwent type I tympanoplasty at Samsung Medical Center from April to December 2014. The subjects were classified into two groups; endoscopic tympanoplasty (ET, n=25), microscopic tympanoplasty (MT, n=48). Demographic data, perforation size of tympanic membrane at preoperative state, pure tone audiometric results preoperatively and 3 months postoperatively, operation time, sequential postoperative pain scale (NRS-11), and graft success rate were evaluated. RESULTS: The perforation size of the tympanic membrane in ET and MT group was 25.3%±11.7% and 20.1%±11.9%, respectively (P=0.074). Mean operation time of MT (88.9±28.5 minutes) was longer than that of the ET (68.2±22.1 minutes) with a statistical significance (P=0.002). External auditory canal (EAC) width was shorter in the ET group than in the MT group (P=0.011). However, EAC widening was not necessary in the ET group and was performed in 33.3% of patients in the MT group. Graft success rate in the ET and MT group were 100% and 95.8%, respectively; the values were not significantly different (P=0.304). Pre- and postoperative audiometric results including bone and air conduction thresholds and air-bone gap were not significantly different between the groups. In all groups, the postoperative air-bone gap was significantly improved compared to the preoperative air-bone gap. Immediate postoperative pain was similar between the groups. However, pain of 1 day after surgery was significantly less in the ET group. CONCLUSION: With endoscopic system, minimal invasive tympanoplasty can be possible with similar graft success rate and less pain.

Early Experience of Non-Linear Frequency Compression Technology in Patients with High-Frequency Hearing Loss / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Consonants are uttered in the high frequency range in speech to bring out understanding of our language. As consonants convey most of the word information, listeners with high-frequency hearing loss find it hard to understand speech. Non-linear frequency compression (NLFC) technology compresses and moves higher frequencies into a lower frequency region where better residual hearing is present. The purpose of this study was to evaluate clinical effectiveness of NLFC technology in patients with high-frequency hearing loss. SUBJECTS AND METHOD: Twelve ears representing patients with sloping, high-frequency sensorineural hearing loss were involved in this study. Pure-tone audiometry and Threshold Equalizing Noise Test were conducted initially in all subjects. The subjects were tested in the counter-balanced order, and had two months of everyday experience with NLFC on/off before testing took place. A resting period intervened the two phases. Performance was repeatedly evaluated with Sound Field Audiometry, Word Recognition Score, Reception Threshold for Sentences and Korean version of International Outcome Inventory for Hearing Aids. RESULTS: Cochlear dead region was detected on 4 kHz of both ears in only one subject. Each subject showed diverse performance and satisfaction with active NLFC condition. Typically, audibility of high-frequency pure-tones improved with NLFC-on condition. However, speech perception both in quiet and noise was not much improved when compared with NLFC-off condition. CONCLUSION: The NLFC technology could improve audibility in high-frequency, but failed to demonstrate benefits regarding speech perception. Further research is needed to validate the effectiveness of the NLFC technology especially in terms of speech intelligibility.

An Evaluation Protocol of the Upper Airway for Pediatric Patients with Stridor or Extubation Failure / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Adequate evaluation of the upper airway is critical in the management of pediatric patients with stridor or extubation failure. For this purpose, we designed an evaluation protocol of the upper airway for these patients, in collaboration with Dept. of Pediatrics, Intensive care team and Anesthesiology. Here we present the clinical results of our evaluation protocol and provide information about the etiology and management of the upper airway problems. SUBJECTS AND METHOD: Clinical data of 380 pediatric patients (M:F=231:149) having airway evaluation for their problems (stridor or extubation failure) were retrospectively analyzed. Among them, patients of age less than 3 months ranked first (30.0%). Comorbidities of pulmonary diseases (30.8%) and cardiovascular diseases (29.5%) were found. The pre and post-evaluation diagnosis, management and prognosis were evaluated and the usefulness of an airway evaluation protocol was discussed. RESULTS: Frequent pre-evaluation diagnoses were subglottic stenosis (55.2%), laryngomalacia (12.6%) and tracheal stenosis (9.2%) and these were changed to subglottic stenosis (44.5%), laryngomalacia (9.7%), tracheal stenosis (6.6%) and no abnormality (14.5%). Particularly, 50% of pre-diagnosis laryngomalacia, 25% of subglottic stenosis and 37% of tracheal stenosis were corrected to other causes by airway evaluation. The procedures were exam only (41.6%), endoscopic dilatation (20.8%) and tracheostomy (17.9%). In 190 out of 380 (50.0%), extubation was successful, but 151 patients (39.7%) had tracheostomy tube. CONCLUSION: Adequate evaluation of the upper airway in pediatric patients with stridor or extubation failure can facilitate the diagnosis and management of their problems.

Central Skull Base Osteomyelitis: 10-Case Series in a Single Center / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Skull base osteomyelitis (SBO) typically evolves as a complication of malignant otitis externa (MOE) in diabetic patients and involves the temporal bone. Central SBO (CSBO), which mainly involves the sphenoid or occipital bones, has clinicaland radiological characteristics similar to those of SBO but without coexisting MOE. We investigated a group of patients with CSBO and studied the clinical course of CSBO. SUBJECTS AND METHOD: Medical records of patients who were diagnosed with CSBO were retrospectively analyzed from 1999 to 2014. RESULTS: Ten patients (mean age; 60.5 years) were identified. There were five males and five females. All patients suffered from headache, and six patients had cranial nerve palsy including oculomotor (20%), abducens (10%), vestibulocochlear (10%), glossopharyngeal (20%), vagus (30%) and hypoglossal (10%) nerve. Patients had underlying diseases including diabetes mellitus (40%), immunosuppression status after liver transplantation (10%) and cardiovascular disease (40%). Four patients received endoscopic biopsy and debridement for diagnostic and curative intent. Patients were treated with intravenous antibiotics for 5.1 weeks in average and oral antibiotics for 17 weeks. Mean follow-up period was 12.4 months and the mortality rate was zero. 40% of patients had residual neurologic deficit. The earliest sign of improving CSBO was headache (mean; 3.1 weeks) and the erythrocyte sedimentation rate was the latest improving sign (mean; 4 months). CONCLUSION: CSBO was diagnostic and therapeutic challenge to the clinicians. The timely diagnosis and long-term antibiotics therapy could avoid a mortality case and minimize the permanent neurologic deficit.

Ceftiaxone-Induced Neurotoxicity: Case Report, Pharmacokinetic Considerations, and Literature Review

Ceftriaxone is widely used in patients for the treatment of serious gram-negative infections. Ceftriaxone can induce some potential side effects, including neurotoxicity, however, nonconvulsive status epilepticus has rarely been reported. We report a case of acute reversible neurotoxicity associated with ceftriaxone. A 65-yr-old woman with chronic kidney disease developed altered consciousness during ceftriaxone treatment for urinary tract infection. The electroencephalogram demonstrated continuous bursts of generalized, high-voltage, 1 to 2 Hz sharp wave activity. Neurologic symptoms disappeared following withdrawal of ceftriaxone. The possibility of ceftriaxone-induced neurotoxicity should be considered in patients developing neurological impairment during ceftriaxone use, and the discontinuation of the drug could lead to complete neurological improvement.