Acoustic features of voice in patients with severe hearing loss.

OBJECTIVE: The aim of this study was to evaluate changes in the acoustic features of voice in patients with sensorineural hearing loss. DESIGN: Thirty male patients, between 35 and 53 years of age with postlingual bilateral symmetric severe sensorineural hearing loss, were included (group A). As a control group (group B), 30 normal-hearing male adults, aged 38 to 51 years, were identified. SETTING: ENT Department, University of Genoa (Italy). METHODS: Phonetically balanced sentences and sustained vowels a, e, and i were digitally recorded with the Multidimensional Voice Program (Kay Elemetrics) in all subjects. MAIN OUTCOME MEASURES: The parameters estimated were the average of fundamental frequency (F0), jitter percent (jitter), shimmer, noise to harmonics ratio (NHR), voice turbulence index (VTI), soft phonation index (SPI), degree of voicelessness (DUV), degree of voice breaks (DVB), and peak amplitude variation (vAm). RESULTS: Compared to the control group, in group A, the following acoustic parameters presented a statistically significantly higher value (p < .05) of F0 (137.2 Hz vs 120.0 Hz), jitter (1.93% vs 0.67%), shimmer (6.67% vs 3.81%), NHR (0.19 vs 0.10), SPI (12.9 vs 8.76), DVB (2.12% vs 0.01%), DUV (9.53% vs 0.51%), and vAm (23.12 % vs 12.06%). In group A, F0 was also significantly higher in the balanced sentences (126 Hz vs 111 Hz). CONCLUSIONS: This study demonstrates that hearing loss affects voice production by changing its parameters, especially in subjects with marked hearing loss.

Ribosomal therapy in patients with pharyngolaryngeal reflux.

CONCLUSIONS: Our data confirm the induction of specific and nonspecific immune responses of the upper respiratory tract mucosa and the consequent improvement of its physiology, through an oral ribosomal therapy in patients with pharyngolaryngeal reflux disease (PLRD). OBJECTIVES: The aim of this study was to investigate the efficiency and applicability of oral ribosomal immunotherapy in adult patients with PLRD. METHODS: One hundred adult patients with PLRD were enrolled. The patients were equally divided, at random, into two groups (A and B): group A patients underwent ribosomal prophylaxis with Immucytal® (one tablet daily, 8 days a month for 3 months), while group B received a placebo (same dosage for the same period). At the beginning, at the end, and 6 months after the beginning of the therapy, all patients underwent medical history, ENT examination, nasal-pharynx-laryngoscopy with optic fiber, plasma levels of immunoglobulins class E, A, G, M, subjective assessment of symptoms on a 10 cm visual analog scale (VAS), reflux symptoms index, and reflux finding score. RESULTS: At the end and 6 months after the beginning of the treatment, all the patients in group A presented a significant (p < 0.05) improvement of almost all the different items analyzed.

Water-soluble coenzyme Q10 formulation in presbycusis: long-term effects.

CONCLUSION: These findings provide the basis for understanding the duration of the effect after the last use of the drug and encourage a larger clinical trial to collect additional evidence on the effect of coenzyme Q10 (CoQ10) in preventing the development of hearing loss in subjects with presbycusis. OBJECTIVES: The aim of this study was to evaluate the long-term effects of a water-soluble formulation of CoQ10 (Q-TER) in subjects with presbycusis. METHODS: Sixty patients with presbycusis were included and divided at random into three numerically equal groups. For 30 days, group A underwent therapy with Q-TER, group B underwent therapy with vitamin E, and group C received placebo. Before, at the end, and 6 months after the end of the treatment, all patients underwent evaluation of pure tone audiometry, transient evoked otoacoustic emissions and otoacoustic products of distortion, auditory brainstem response, and speech audiometry. RESULTS: Compared with group B, at the end of the treatment in group A the pure tone audiometry showed a significant (p < 0.05) improvement of the audiometric thresholds at 1000, 2000, 4000, and 8000 Hz. This improvement was confirmed by the speech audiometry and last check. We found no significant differences in the other parameters and in group C.

Nasal tactile sensitivity in elderly.

CONCLUSION: Although older people varied widely in tactile sensitivity, our results show that tactile thresholds increased with age. OBJECTIVES: The aim of this study was to evaluate the effects of aging on nasal tactile sensitivity. METHODS: A total of 160 healthy patients aged between 50 and 90 years were included. According to their age, patients were divided into groups (A, B, C, D, E, F, G, and H). From the age of 50, each group included subjects with an age range of 5 years (i.e. group A, 50-55 years; group B, 56-60 years, etc.). Each patient's outcome was assessed through the nasal monofilament test: a set of 20 Semmes-Weinstein monofilaments was used to detect nasal sensitivity for both nasal cavities. The sensitivity threshold was recorded as the minimum monofilament size from which patients could detect at least two of three stimuli. RESULTS: In groups D (66-70 years), E (71-75 years), F (76-80 years), G (81-85 years), and H (86-90 years) a significantly (p < 0.05) higher stimulus (171.1 ± 0.34 mg vs 67.7 mg, 167.01 ± 0.31 mg 67.7 mg, 166.54 ± 0.28 mg 67.7 mg, 201.24 ± 0.43 mg 67.7 mg, 165,87 ± 0.27 mg 67.7 mg) was required to trigger a touch response in the monofilament test.

Computerized voice therapy in hypofunctional dysphonia.

OBJECTIVE: The aim of this study was to analyze the efficiency and applicability of the Kay CSL 4500 system with the Sona-Speech II software model 3650 (Kay Pentax, Lincoln Park, NJ) in the voice therapy of patients affected by hypofunctional dysphonia. DESIGN: The study evaluated the effect of visual biofeedback, obtained with the Sona-Speech II software, on dysphonia associated with hypofunction dysphonia. SETTING: The study was conducted with 40 male adults affected by hypofunctional dysphonia in the Otolaryngology Department of the University of Genoa (Italy) between April 2008 and April 2009. METHODS: Before, at the end of, and 3 months after voice therapy, all subjects underwent an otolaryngology visit, videostroboscopy, and voice analysis through the Multi-Dimensional Voice Program (Kay Elemetrics, Lincoln Park, NJ) as an evaluation of nasal resonance and the Voice Handicap Index (VHI). Each cycle of rehabilitation was characterized by 30 daily consecutive sessions, each for 25 minutes. During each session, the patient was asked to perform specific computer exercises. MAIN OUTCOME MEASURES: The following acoustic parameters were estimated: average of fundamental frequency, percentage of jitter, shimmer, noise to harmonics ratio, voice turbulence index, soft phonation index, degree of voicelessness, degree of voice breaks, and peak amplitude variation. RESULTS: Our data showed significant (p < .05) improvements in acoustic and other parameters in the patients submitted to voice therapy. CONCLUSIONS: Our preliminary results suggest the applicability and efficiency of the Kay CSL 4500 system in association with the Sona-Speech II software model 3650 in a voice therapy program.

Piezosurgery versus microdrill in intact canal wall mastoidectomy.

Piezosurgery is a recently developed system for cutting bone with microvibrations. The objectives of the present study were to report our experience with the piezoelectric device in the intact canal mastoidectomy, and to compare the results with traditional method by means of microdrill. A non-randomized controlled trial was undertaken on 60 intact canal wall mastoidectomy performed using the piezoelectric device (30 patients) or the microdrill (30 patients). Before 1 month and 1 year after surgery, all the patients underwent the following instrumental examinations: otomicroscopic evaluation of the tympanic membrane and external auditory duct, bone conduction threshold audiometry, tympanometry, transient-evoked otoacoustic emissions with linear click emission, distortion product otoacoustic emissions, auditory brainstem response (ABR) by MK 12-ABR screener with natus-ALGO2e (Amplifon, Milan, Italy), and electronystamographic recording. The piezoelectric device is proved to be effective in sclerotic and pneumatic mastoid, with an excellent control and without side effects on the adjacent structures of the middle and inner ear (lateral sinus, facial nerve, and/or dura mater). The operation time has been the same as compared with microdrill, and the average hospital stay was significantly (p < 0.05) shorter. Postoperatively, all patients had uneventful recovery with no evidence of audiovestibular deficit or side effects. Our experience highlights the safety of the piezoelectric device on the anatomic structures of the middle and inner ear, and demonstrates its efficiency in terms of cutting precision and healing process.

Water-soluble coenzyme Q10 formulation (Q-TER(®)) in the treatment of presbycusis.

CONCLUSION: These preliminary data are encouraging for a larger clinical trial to collect additional evidence on the effect of Q-TER(®) in preventing the development of hearing loss in subjects with presbycusis. OBJECTIVES: The purpose of this study was to evaluate the efficiency and applicability of a water-soluble formulation of CoQ10 (Q-TER(®)) in subjects with presbycusis. METHODS: A total of 60 patients with presbycusis were included and divided into three numerically equal groups. Group A underwent therapy with Q-TER(®), 160 mg, once a day for 30 days; group B underwent therapy with vitamin E (50 mg), once a day for 30 days; group C received placebo, once a day for 30 days. Before and at the end of the treatment, all patients underwent pure tone audiometry, transient evoked otoacoustic emissions, otoacoustic products of distortion, auditory brainstem response, and speech audiometry. RESULTS: Compared with group B, at the end of the treatment in group A the liminar tonal audiometry showed a significant improvement of the air and bone thresholds at the 1000 (14/20 vs 9/20), 2000 (14/20 vs 7/20), 4000 (15/20 vs 6/20), and 8000 Hz (13/20 vs 5/20). We found no significant differences in the other parameters and in group C.

Evaluation of an automated auditory brainstem response in a multi-stage infant hearing screening.

An automated auditory brainstem response (AABR) method, the Maico MB-11 with BERAphone, has been developed for hearing screening in newborns. The aim of this study was to test the validity of this automated ABR screening method in a multistage newborn hearing screening (NHS). We applied a "five level" protocol using transient evoked otoacoustic emission (TEOAE), AABR-MB-11 with BERAphone and conventional auditory brainstem response (ABR). TEOAE, AABR, and conventional ABR testing were performed by ENT specialists experienced in neonatal screening techniques. Among the 8,671 newborns tested (males 3,889; females 4,782), only 42 newborns were lost to follow-up and the final false-positive rate was of 0.03%. Our experience highlights that for the neonatal period, conventional auditory brainstem response is the most reliable method for assessing the hearing level and minimizing the false-positive rate. Although AABR (performed by ENT specialists experienced in neonatal screening techniques) is easy to use, fast and with a good compliance, the device is unable to provide accurate and certain diagnosis on the degree of hearing loss to allow a proper treatment.

Ribosomal therapy in the treatment of recurrent acute adenoiditis.

The aim of this study was to evaluate the efficacy of an oral ribosomal immunotherapy in the management of children with recurrent acute adenoiditis (RAA). 60 children with RAA were included and randomly assigned into two groups (group A and B). Group A children underwent ribosomal prophylaxis, while group B received a placebo. Before, at the end and 6 months after start of the therapy, children underwent medical history, ENT examination, plasma levels of immunoglobulins class E, A, G, M (IgE, IgA, IgG, IgM), tympanometry, active anterior rhinomanometry and VAS scores by children' parents. After the treatment and at the end of the study, in the group A, the serum concentration of IgE was significantly (P < 0.05) lower than in group B (77.34 +/- 6.23 vs. 95.49 +/- 7.07 mg/dl; 74.82 +/- 6.26 vs. 94.44 +/- 7.44 mg/dl), IgA titers were significantly (P < 0.05) higher than in group B (312.04 +/- 18.41 vs. 213.20 +/- 11.82; 309.07 +/- 18.33 vs. 211.73 +/- 11.54 mg/dl) as well as serum concentration of IgG (1401.12 +/- 118.81 vs. 1101.81 +/- 109.64 mg/dl; 1412.19 +/- 116.43 vs. 1144.06 +/- 103.58 mg/dl). At the end of the study, comparison between the two groups showed, in group A: 77% of children (n = 23), versus 23% (n = 7) of group B, with a type A tympanogram; significant (P < 0.05) nasal flow decrease at the rhinomanometric measures; VAS scores were significantly (P < 0.05) improved (1.8 +/- 0.22 vs. 5.1 +/- 0.59) and frequency, severity and social impact of RAA episodes were significantly (P < 0.05) lower than group B. Our results show the therapeutic effectiveness of this approach in the prophylaxis of recurrent acute adenoiditis.