Objective Analysis Of Voice Quality In Patients With Thyroid Pathology.

OBJECTIVE: The goal of this study is to analyze the voice in patients with thyroid pathology through two objective indexes with great diagnostic accuracy. Overall vocal quality was evaluated with the Acoustic Voice Quality Index (AVQI v.03.01) and the breathy voice with the Acoustic Breathiness Index (ABI). DESIGN: Observational case-control study. SETTING: Hospital Universitario Nuestra Señora de Candelaria. PARTICIPANTS: Fifty-eight subjects, 29 controls and 29 thyroidectomy candidates. MAIN OUTCOME MEASURES: All participants with thyroid pathology completed the Spanish version of Voice Handicap Index-10. Also, patient complaints relating to possible laryngeal dysfunction were assessed through closed questions. A sustained vowel and three phonetically balanced sentences were recorded for each subject (118 samples). AVQI v.03.01 and ABI were assessed using the Praat program. Two raters perceptually evaluated each voice sample by using the Grade parameter of GRABS scale. RESULTS: Acoustic analysis shows that 55.17% of subjects present values above the pathological threshold of the AVQI, and 58.62% above that of the ABI. Results of the Student's test comparisons of the AVQI and ABI values between the control group and the thyroid group show significantly higher values of AVQI (t[56]  = -3.85, p < .001) and ABI (t[54.39]  = -4.82, p < .001) in thyroidectomy candidates. CONCLUSION: A mild decrease in vocal quality is part of the symptomatology presented by thyroidectomy candidates.

Metástasis de adenocarcinoma de vesícula biliar a piel de conducto auditivo externo, a propósito de un caso / Metastasis of gallbladder adenocarcinoma to the skin of the external auditory canal, a case report

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[Nasal leprosy: impact of multitherapy in the morphology and physiology of the nose]. / Lepra nasal: impacto de la multiterapia en la morfología y la fisiología nasal.

INTRODUCTION: The multi-drug therapy protocol has allowed leprosy patients following this strategy to achieve complete recovery without developing neurotrophic sequelae or deformities. OBJECTIVES: To assess the impact of multi-drug therapy on the development of nasal deformities and nasal airway patency. PATIENTS AND METHOD: In an overall group of 84 patients studied, 38 were treated with a therapy based on a single drug and 22 were treated with multi-drug while 24 subjects formed a control group. Nose morphology was determined by anterior rhinoscopy. Nasal patency and flow resistances were measured by anterior rhinomanometry. The results were compared by using the Anova test for a single variable. RESULTS: The nasal structures in the group with therapy based on a single drug underwent resorption of bone and cartilage in the structures of the nose and increased flow resistance. In the group receiving the multi-drug protocol, there were no significant morphological alterations and nasal patency and flow resistance remained within normal levels. CONCLUSIONS: The multi-drug therapy is effective in preventing the development of nasal deformities and maintains normal nasal airflow.

Lepra nasal: impacto de la multiterapia en la morfología y la fisiología nasal / Nasal leprosy: impact of multitherapy in the morphology and physiology of the nose

Introducción: El protocolo de terapia combinada ha permitido que los enfermos de lepra tratados según esta estrategia alcancen una curación sin secuelas neurotróficas ni deformidades. Objetivos: Determinar el impacto de la multiterapia en el desarrollo de las alteraciones del esqueleto óseo cartilaginoso y en la función respiratoria nasal. Pacientes y método: Estudiamos a 84 sujetos: 38 pacientes tratados con monoterapia, 22 pacientes tratados con multiterapia y 24 sujetos control. Exploramos la morfología nasal mediante rinoscopia anterior y la función respiratoria nasal mediante rinomanometría anterior activa. En el análisis estadístico se ha utilizado el test ANOVA de un factor. Resultados: En el grupo de monoterapia observamos una reabsorción osteocartilaginosa de las estructuras nasales y un aumento de las resistencias nasales. Los pacientes que recibieron multiterapia no presentaron cambios morfológicos significativos y la función respiratoria nasal se mantuvo dentro de la normalidad. Conclusiones: La terapia combinada es eficaz porque previene la aparición de deformidades nasales y la insuficiencia respiratoria nasal

Introduction: The multi-drug therapy protocol has allowed leprosy patients following this strategy to achieve complete recovery without developing neurotrophic sequelae or deformities. Objectives: To assess the impact of multi-drug therapy on the development of nasal deformities and nasal airway patency. Patients and method: In an overall group of 84 patients studied, 38 were treated with a therapy based on a single drug and 22 were treated with multi-drug while 24 subjects formed a control group. Nose morphology was determined by anterior rhinoscopy. Nasal patency and flow resistances were measured by anterior rhinomanometry. The results were compared by using the Anova test for a single variable. Results: The nasal structures in the group with therapy based on a single drug underwent resorption of bone and cartilage in the structures of the nose and increased flow resistance. In the group receiving the multi-drug protocol, there were no significant morphological alterations and nasal patency and flow resistance remained within normal levels. Conclusions: The multi-drug therapy is effective in preventing the development of nasal deformities and maintains normal nasal airflow