Voice Assessment After Treatment of Subacute and Chronic Cough With Inhaled Steroids.

INTRODUCTION: Inhaled steroids are widely used for persistent cough treatment. Although the side effects of long-term inhaled steroids have been well described in the literature, their laryngeal side effects after short-term use have not yet been defined. The aim of this study was to evaluate the effect of 1 month application of inhaled steroid treatment on voice parameters in patients with subacute or chronic cough. Furthermore, the efficacy of inhaled steroids on cough was investigated, as well. MATERIAL AND METHODS: This study included 46 patients (27 females and 19 males) with a persistent cough lasting at least 3 weeks and treated with inhaled steroids. All patients were examined by a pulmonologist and lung auscultation where a posteroanterior chest X-ray and spirometry were performed. The patients were also examined by an otolaryngologist. Anterior rhinoscopy, flexible fiberoptic nasopharyngoscopy, and laryngostroboscopy were performed. Also, the patients' acoustic voice analyses were performed and recorded using a multidimensional voice program. Cough symptom index (CSI) scores were used to evaluate the response to treatment. Patients with an underlying disease that was unresponsive to inhaled steroids were excluded from study. The 46 patients were administered inhaled budesonide 400 mcg twice a day, for 1 month, and their acoustic voice analyses were performed again at the end of the treatment. In addition, CSI scores were determined after stopping medication. RESULTS: When pretreatment and posttreatment acoustic voice analysis parameters (Fo, Jita, Jitt, Shim, APQ, vAm, and NHR) were compared, statistically significant differences were detected for vAm (P = 0.001) and F0 (P0.003). After treatment with inhaled steroids, the CSI score reduced from 3 to 1 (median), and the difference was statistically significant. CONCLUSIONS: Inhaled budesonide treatment in the proper dose seems to be an effective treatment for persistent cough, in the selected patient group. In addition, short-term budesonide application did not cause any negative effects on the voice parameters in these patients. These findings may be related to the steroid formulation used, the application method, and the duration of treatment. Further studies are needed on a larger group of patients with different formulations of inhaled steroids to clarify aforementioned issues.

Effect of preoperative mastoid ventilation on tympanoplasty success.

Purpose. This study was conducted with the aim of investigating the relationship between mastoid air cell volumes and graft success after tympanoplasty. Material and Methods. This study was performed retrospectively with patients undergoing type I tympanoplasty and antrostomy. A total of 57 patients (20-35.09% female and 37-64.91% male) with a mean age of 29.69 ± SD (range 12-56 years) were included in the study. The patients were invited for a control at the 1st, 3rd, and 12th months, and otoscopic examinations and audiometric tests were performed. The temporal bone computed tomography images were screened with the 4800 Dpi optic resolution scanner and transferred to the computer environment in JPG format in order to calculate the mastoid air cell volume, and the volumes were calculated using the Autocad 2007 program. Results. Although, the graft success was determined to be better in the well-ventilated group, no significant difference could be found between the groups in terms of graft success at the 1st, 3rd, and 12th months (P > 0.05). No statistically significant difference could be found between the three groups in terms of the preoperative and postoperative hearing gains (P > 0.05).

Nasalance scores in pediatric patients after adenoidectomy.

OBJECTIVE: Adenoidectomy is one of the most frequently performed operations in childhood. Nasal obstruction and chronic infection are the basic indications for surgery. Nasometer measures both oral and nasal air pressure during loud speech, and calculates their ratio. The aim of this study was to compare the mean nasal values in patients who had adenoidectomy at different ages against a control group. METHODS: Eighty children between the ages of three and sixteen that had adenoidectomy in our clinic between 2006 and 2010 were compared against eighty age-matched controls who had not had nasal obstruction in their lifetime and were proven to have open nasal airways on physical examination. RESULTS: Statistical analysis of the data showed that mean nasalance scores were significantly lower in patients who had adenoidectomy before 6 years of age when compared to the ones who had the operation after the age of six. In addition, when we compared the children who had adenoidectomy before 5 years of age and between 5 and 6 years of age, we found that their nasalance scores were significantly lower when compared to those who had adenoidectomy after the age of six (p = 0.017 and p = 0.019, respectively). CONCLUSION: This study has shown that, even when adenoidectomy is performed, hyponasality may continue in clinically symptomatic patients under the age of six, and that there are no determined risk factors other than the early age.