Voice outcome with provox prosthesis after total laryngectomy

The treatment and method of rehabilitation of laryngeal cancer depends on the clinical staging and site of the tumour .The early detection of laryngeal cancer and less tissue loss leads to good results of rehabilitation. Current methods of vocal rehabilitation after total laryngectomy include development of esophageal speech, use of electro-larynx and Trach-eoesophageal fistula with prosthesis. Also the early detection of laryngeal cancer will make a minor tissue loss after procedures, and so limit the problems of rehabilitation [speech and swallowing]. The aim of this study is to compare the voice results of patients who underwent: total laryngectomy with provox prosthesis and conservative laryngectomy. This study included 2 groups; 19 patients who underwent laryngectomy for control of laryngeal carcinoma subdivided into 2 groups according to surgical procedures 9 patients with total laryngectomy with provox processes and 10 patients with conservative laryngectomy and 6 normal as control group. After voice analysis for the two test groups and comparison to the control group, there was significant difference between conservative group and provox group as regards intelligibility score and number of words per minute and also Shimmer and noise to harmonic tests of this study showed that conservative laryngectomy group is relatively better than provox group in many parameters of analysis; this may be due less tissue loss in conservative group

Intratympanic dexamethasone in diabetic and hypertensive patients with sudden sensorineural hearing loss

Systemic steroid therapy has been considered a mainstay for treatment of idiopathic sudden sensorineural hearing loss [ISSNHL], specially among those who suspect a viral etiology. Unfortunately, some patients are poor candidates for systemic steroids. The aim of the present study is to evaluate the efficacy of intratympanic dexamethasone injection for diabetic and hypertensive patients with SSNHL in whom systemic steroid therapy is hazardous. This study was undertaken prospectively on 26 diabetic and hypertensive patients with unilateral moderately severe and severe SSNHL in whom there was a history of a recent upper respiratory tract infection. The patients were 14 men [53.8%] and 12 women I with an age range 43-68 years. Under local anaesthesia. 0.5 ml of dexamethasone [24 mg/mi] was injected in the tympanic cavity. injection was performed on three separate occasions over 10 days. Hearing was assessed by pure-tone and speech audiometry immediately before, twice weekly during therapy and within 3 weeks after therapy was discontinued. Pure-tone average [500, 1000 and 2000Hz] improved in 15 patients [57, 7%]. 7 patients [27%] recovered to normal hearing threshold levels 5 patients [19.2%] improved to a degree of mild hearing loss and :3 patients [11.5%] improved to a degree of moderate hearing loss. A hearing recovery rate of 57.7% in ISSNHL could be considered a good and encouraging response rate in a group of patients who an not tolerate systemic steroid therapy and may be considered beyond therapeutic reach