VOICE DISORDERS & OTOLARYNGOLOGY

Involvement of Ear in Rheumatoid Arthritis

2011-08-02T16:00:00.001-07:00

Involvement of Ear in Rheumatoid Arthritis. Prospective Clinical StudyObjective: To investigate the relationship of the degree of hearing loss seen in rheumatoid arthritis (RA) and biochemical findings of the disease.
Materials and methods: This study was carried out with 44 RA patients and 44 voluntary healthy controls between November 2006 and June 2007. All members underwent audiometry and impedance audiometry. The duration of the disease, the drugs used for the disease and the biochemical findings of the patients were noted.
Results: Presbyacusis type sensorial hearing loss was detected in 27.3% of the patients and 15.9% in controls. Subclinic conductive hearing loss was seen in 56.8% of the patients and 25% of controls (p<0.01) and much more at frequencies of 500 Hz and 1000 Hz. The reason of this was seemed as the stiffness of the ossicular chain in patients.
Conclusion: Sensorineural hearing loss in RA is like presbyacusis and not statistically significant. However especially subclinic conductive pattern of hearing loss at low frequencies may be an indicator to predict the ossicular joint involvement in RA patients.

Int. Adv. Otol. 2011; 7(2): 208-214.

Adverse Effect of Noise on Voice Perturbation Estimates: A Comparison of Three Voice Analysis Programs

2011-06-02T22:06:00.000-07:00

doi: 10.5336/medsci.2010-19461
Turkiye Klinikleri J Med Sci 2011;31(2):427-31
Mehmet Akif KILIÇ MD, Haldun OĞUZ MD, Fatih ÖĞÜT MD.
Objective: The aim of this study is to investigate the influence of noise on voice perturbation outputs obtained by three different voice analysis programs, and to show the software more immune to noise.
Material and Methods: For this purpose, 10 natural and 10 semi-synthetic voice samples were recorded. They were mixed with environmental noise and white noise. The unmixed and mixed signals were analyzed by Dr. Speech, MDVP and Praat. Three frequency perturbation outputs (jitter percent, relative average perturbation and pitch perturbation quotient) and two amplitude perturbation outputs (shimmer percent and amplitude perturbation quotient) were obtained. The unmixed and mixed signals were compared. Correlations were calculated between natural unmixed and natural mixed ones.
Results: The frequency perturbation outputs obtained by Dr. Speech and Praat seemed to be less affected by noise. However, the amplitude perturbation values measured by three systems were severely affected by noise, but Praat's performance found mildly better than the others'. Correlation analyses for 10 items (five parameters x two noise situations) revealed that there were perfect correlations (r= 1.000) regarding six items for Praat, three items for Dr. Speech and one item for MDVP.
Conclusion: As a conclusion, it was decided that Praat was the most immune one to noise among three analysis systems, followed by Dr. Speech and MDVP, respectively.

Surgical Techniques in ENT

2010-11-20T01:53:00.001-08:00

Dear Friends and Colleagues,

International "Surgical Techniques in ENT" meeting will be held on 22-24 April, 2011. The meeting site is Ephesus/Kusadasi, Turkey. The official meeting language is English. Please find additional details at www.ent2011.org. If you need additional information do not hesitate to contact me.

I would be very pleased if you could kindly share this information with your friends and colleagues.

Sincerely,

Haldun OGUZ, M.D., Associate Professor of Otolaryngology

Scientific Secretary

+ 90 533 300 00 00

www.ent2011.org

Perceptual evaluation of voice quality: review, tutorial, and a framework for future research

2010-08-24T04:17:00.000-07:00

The reliability of listeners' ratings of voice quality is a central issue in voice research because of the clinical primacy of such ratings and because they are the standard against which other measures are evaluated. However, an extensive literature review indicates that both intrarater and interrater reliability fluctuate greatly from study to study. Further, our own data indicate that ratings of vocal roughness vary widely across individual clinicians, with a single voice often receiving nearly the full range of possible ratings. No model or theoretical framework currently exists to explain these variations, although such a model might guide development of efficient, valid, and standardized clinical protocols for voice evaluation. We propose a theoretical framework that attributes variability in ratings to several sources (including listeners' backgrounds and biases, the task used to gather ratings, interactions between listeners and tasks, and random error). This framework may guide development of new clinical voice and speech evaluation protocols, ultimately leading to more reliable perceptual ratings and a better understanding of the perceptual qualities of pathological voices. Kreiman J et al. JSHR, 1993; 36:21-40.

The reliability and validity of patient self-rating of their own voice quality

2010-06-07T10:51:00.001-07:00

According to Lee et al. patients appear to have good validity and consistency using GRBAS as a self-perception tool. This tool is used among clinicians to subjectively assess the general and partial quality of voice. Although, consistent among themselves, patients do not have an agreement with clinicians. Patients and clinicians have an inter-rater agreement no better than chance and they rated consistently more severely than clinicians. Full text: Lee M, et al. The reliability and validity of patient self-rating of their own voice quality. Clin Otolaryngol 2005; 30:357-61.

Voice Disorders Web Site References

2010-03-06T05:18:00.001-08:00

11. Aronson AE, Bless DM. Clinical Voice Disorders, Thieme, 2009.

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Haldun OGUZ, M.D., Associate Professor of Otolaryngology
Ministry of Health, Ankara Training & Research Hospital
Department of Otolaryngology
Ankara, TURKIYE
drhoguz@gmail.com
http://hoguz.blogspot.com
GSM. +90 533 300 00 00
Tel. +90 312 595 35 61 - +90 312 595 35 65
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Esophagogastric Junction Anatomy in Patients with Isolated Laryngopharyngeal Reflux Symptoms.

2008-08-12T05:01:00.001-07:00

Perry KA, et al.

The Integrity of Esophagogastric Junction Anatomy in Patients with Isolated Laryngopharyngeal Reflux Symptoms.

J Gastrointestinal Surgery, preprint.

Distortion of esophagogastric junction anatomy in patients with gastroesophageal reflux disease produces permanent dilation of the gastric cardia proportional to disease severity, but it remains unclear whether this mechanism underlies reflux in patients with isolated laryngopharyngeal reflux symptoms. METHOD: In a prospective study, 113 patients were stratified into three populations based on symptom complex: laryngopharyngeal reflux symptoms, typical reflux symptoms, and both laryngopharyngeal and typical symptoms. Subjects underwent small-caliber upper endoscopy in the upright position. Outcome measures included gastric cardia circumference, presence and size of hiatal hernia, and prevalence of esophagitis and Barrett's esophagus within each group. RESULTS: There were no differences in gastric cardia circumference between patient groups. The prevalence of Barrett's esophagus was 20.4% overall and 15.6% in pure laryngopharyngeal reflux patients. Barrett's esophagus patients had a greater cardia circumference compared to those without it. In the upright position, patients with isolated laryngopharyngeal reflux display the same degree of esophagogastric junction distortion as those with typical reflux symptoms, suggesting a similar pathophysiology. CONCLUSION: This indicates that, although these patients may sense reflux differently, they have similar risks as patients with typical symptoms. Further, the identification of Barrett's esophagus in the absence of typical reflux symptoms suggests the potential for occult disease progression and late discovery of cancer.
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ELS ENDOSKOPIK KORDEKTOMI SINIFLAMASI

2006-11-28T18:35:00.000-08:00

1 subepitelyal

2 subligamental

3 transmuskuler

4 total

4a genişletilmiş (karşı kord)

4b genişletilmiş (aritenoid)

4c genişletilmiş (ventriküler fold)

4d genişletilmiş (subglottis)
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Dr. Hâldun OĞUZ
drhoguz@gmail.com

STEROID EŞDEĞERLİK TABLOSU

2006-11-27T13:27:00.000-08:00

25 Cortisone

20 Hydrocortisone

05 Prednisolone

05 Prednisone

04 Methylprednisolone

04 Triamcinolone

02 Paramethasone

00.75 Betamethasone

00.75 Dexamethasone

Kaynak: http://www.rxlist.com/cgi/generic/dexameth_ids.htm
--
Dr. Hâldun OĞUZ
drhoguz@gmail.com

EFFECTS OF UNILATERAL VOCAL CORD PARALYSIS ON OBJECTIVE VOICE MEASURES OBTAINED BY PRAAT

2006-09-24T05:33:00.000-07:00

Oğuz H, Demirci M, Safak MA, Arslan N, Islam A, Kargın S.
European Archives of Otolaryngology, in press, author copy, abstract only.

ABSTRACT
Background: Unilateral vocal cord paralysis (VCP) affects the objective properties of voice by diminished neurologic control and degenerative changes in laryngeal tissue.
Objective: Comparison of acoustic parameters of VCP patients with control volunteers with software Praat.
Method: Acoustic analysis results of 18 unilateral VCP patients were compared with age and sex matched 72 normal adult volunteers.
Results: Comparison of acoustic analysis results of male and female VCP patients with their age and sex matched control groups revealed statistically significant difference in jitter, shimmer and noise-to-harmonics ratio values (p<0.01) in both groups. There were no differences in mean fundamental frequency and intensity values.
Conclusions: These differences were in accordance with the results obtained by commercially available voice analysis programs. This study reflects the first results obtained with Praat software in VCP patients. Using the software Praat, is free and easy, that supports the clinician to rely on objective scientific data.
KEY WORDS: vocal cord paralysis, Praat, voice

BRACHYTHERAPY

2006-08-16T01:11:00.000-07:00

Brachytherapy is radiation treatment given by placing radioactive material directly in or near the target, which is often a tumor. The opposite of brachytherapy is teletherapy, treatment in which the radiation source is at a distance from the target.

SUPRAGLOTTİK KOMPRESYON EVRELEMESİ

2006-06-04T12:20:00.000-07:00

	Horizontal	Anteroposterior
Normal	VB kompresyonu yok	Epiglotların aritenoidlere doğru kompresyonu yok
Hafif	VC.ların 1:2'den fazlası görülebiliyor	VC.ların 1:2'den fazlası görülebiliyor
Orta	VC.ların 1:2'den azı görülebiliyor	VC.ların 1:2'den azı görülebiliyor
Ciddi	VB.lar temas halindedir	Epiglot ve ritenoidler temas halinde ve VC.lar hiç görülemiyor.

J Voice Mart 2006 doi:10.1016/j.jvoice.2004.10.007

Çeviri: Dr. Haldun OĞUZ

LARİNKS KANSER EVRELEMESİ

2006-05-06T13:13:00.000-07:00

LARİNKS KANSER EVRELEMESİ

AJCC 2002

SUPRAGLOTTİS

T1 Unilateral, supraglottisin bir bölgesine sınırlı

T2 >1 supraglottik bölgede

Veya

Glottis, vallekula, dil kökü, piriform sinüs medial duvarı tutulumlarından biri

T3 VC fiksasyonu

Veya

Preepiglotik boşluk, postkrikoid tutulumlardan birisi

T4a Tiroid kıkırdak tutulumu veya nonlaringeal yumuşak doku tutulumu

T4b Prevertebral boşluk veya mediasten invazyonu, karotis invazyonu

GLOTTİS

T1 VC'a sınırlı, ön veya arka komissür tutulumu olabilir

T2 Tümör supraglottis ya da subglottise uzanmış, VC hareketleri etkilenmiş

T3 VC fiksasyonu

T4a Tiroid kıkırdak tutulumu veya nonlaringeal yumuşak doku tutulumu

T4b Prevertebral boşluk veya mediasten invazyonu, karotis invazyonu

SUBGLOTTİS

T1 Subglottise sınırlı

T2 VC'a yayılmış, VC hareketi normal ya da kısıtlı

T3 VC fiksasyonu

T4a Tiroid kıkırdak tutulumu veya nonlaringeal yumuşak doku tutulumu

T4b Prevertebral boşluk veya mediasten invazyonu, karotis invazyonu

N0 Nod negaitf

N1 Unilateral tek <= 3 cm

N2a Unilateral tek 3-6 cm

N2b Unilateral birden fazla <6 cm

N2c Bilateral veya kontralateral birden fazla <6 cm

N3 Tek yada birden fazla >6 cm

M0 Uzak metastaz yok

M1 Uzak metastaz var

EVRELEME

Evre I T1

Evre II T2

Evre III T3 veya N1

Evre IVa T4a veya N2

Evre IVb T4b veya N3

Evre IVc M1

--
Dr. Hâldun OĞUZ
http://hoguz.blogspot.com

KISACA

2006-03-01T12:01:00.000-08:00

Dr. Haldun OĞUZ, Hacettepe Üniversitesi Tıp Fakültesi İngilizce Tıp bölümünü bitirdi. 1997 yılında Sağlık Bakanlığı Ankara Eğitim ve Araştırma Hastanesi Kulak Burun Boğaz Kliniğinde uzmanlık eğitimine başladı. 2001 yılında Kulak Burun Boğaz Hastalıkları uzmanı oldu. 2001 yılından bu yana Sağlık Bakanlığı Ankara Eğitim ve Araştırma Hastanesi Kulak Burun Boğaz Kliniğinde başasistan olarak görev yapmaktadır. Ses hastalıkları konusunda yurt dışında çeşitli toplantı ve kurslara katılan Dr. Haldun OĞUZ, 2005 yılında Harvard Üniversitesi Laringoloji ve Ses Restorasyonu Enstitüsünde (Institute of Laryngeal Surgery and Voice Restoration) eğitim almıştır. Kulak Burun Boğaz ve Ses Hastalıkları alanında çok sayıda uluslararası ve ulusal bilimsel yayını bulunmaktadır. Dr. Oğuz, 2007 yılında doçentlik ünvanına layık görülmüştür. Çok iyi derecede İngilizce bilmektedir, evli ve iki kız çocuk babasıdır. Halen, Kulak Burun Boğaz ve Baş Boyun Cerrahisi Derneği ile Profesyonel Ses Derneği'nin yönetim kurulu üyesidir.

Ana Sayfa

Vocal Warm-ups

2006-02-08T11:08:00.000-08:00

http://www.gbmc.org/voice/vocalwarmups.cfm

SES RAHATSIZLIĞI OLAN HASTADA DEĞERLENDİRME

2006-01-14T17:22:00.000-08:00

1. Birlikte değerlendirme

2. Hikaye alma, sorunun kronolojisinin çözümlenmesi

2.1.Genel anamnez formu ss. 3.4

2.2.Ses anamnez formu s.6

2.3.Disfoni değerlendirme modeli

2.3.1 Disfoni platformu bileşenlerinin değerlendirilmesi

2.3.1.1 Teknik ve ses yeteneği

2.3.1.2 Yaşam şekli ve meslek

2.3.1.3 Psikolojik faktörler : Kişilik ve duygular

2.3.1.4 GÖR ve diğer ilişkili tıbbi rahatsızlıklar

2.3.2 Üstte yatan patolojinin değerlendirilmesi

2.3.2.1 Nöromuskuler fonksyion bozuklukları : VKP, distoni, tremor, Parkinson, ALS ve ilişkili dejeneratif rahatsızlıklar, beyin hasarı ve inme

2.3.2.2 Mukozal sorunlar : Akut veya kronik inflamasyon, nodül, polip, kontak ülser ve granülom, kist, sulkus, neoplazi

2.4.Akustik ve algısal değerlendirme

2.4.1 Akustik ve algısal değerlendirme formu s.14

2.4.2 Kayıt araçları ve protokolleri

2.4.3 FF ve perde, intensite ve ses şiddeti ile ilgili ölçümler

2.4.4 Süre, hız ve prozodi ile ilişkili ölçümler

2.4.5 Ses kalitesi ile ilişkili ölçümler

2.4.5.1 Voice Profile Analysis Protocol Form s.20

2.4.5.2 Bipolar akustik algısal derecelendirmeler s.21

2.4.6 Konuşmanın akustik analizi

2.5. Aerodinamik değerlendirme

2.5.1 Ortalama fonatuar akım hızı MPFR

2.5.2 Akım Hacmi FV

2.5.3 Basınç ve rezistans

2.5.4 Akım glottogramı

2.5.5 Aerodinamik değerlendirme protokolü

2.6. İskelet ve kas değerlendirmesi

2.6.1 Vücut duruş bozukluğu belirteçleri

2.6.2 Fonasyon sırasındaki spesifik kas kötü kullanımları

2.7. Larinksin fizik muayenesi

2.7.1 Gerekli aletler

2.7.2 Bölgesel değerlendirme

2.7.2.1 Boyun kasları palpasyon tekniği s.38

2.7.2.2 Larinks dışı kas gerginliği evreleme kriterleri s.39

2.7.3 Ses telleri titreşim paterninin aletsel değerlendirmesi

2.7.3.1 Devamlı ışıkla değerlendirilen fonatuar parametreler:

* Abdüksiyon ve addüksiyon hareketlerinin hız, genişlik (range) ve simetrisi;

* laringeal diadokokinezi;

* glottal ve supraglottal postür;

* vokal fold kenarları.

2.7.3.2 Laringostroboskopi ile değerlendirilen fonatuar parametreler:

* amplitüd

* amplitüd simetrisi

* glottal kapanma paterni; tam, posterior chink, anterior chink, kum saati (ant ve post chink), irregüler chink, bowing (spindle şekilli), veya bunlardan birkaçının kombinasyonu.

* mukozal dalga

* faz kapanma: ortalama bir vibratuar siklusta açık fazın kapalı faza oranıdır, ses şiddeti ve perdesi ile değişir.

* faz simetrisi: amplitüd simetrisinden farklı olarak bu da dikkate alınmalıdır. Vokal fold kitlesinin, kas tonusunun veya pozisyonunun eşit olmamasından kaynaklanabilir.

* regülarite ve periodisite

* vokal foldların vertikal yaklaşım seviyesi

* viskozite ve sertlik: titreşmeyen bölümler

* supraglottik aktivite

* Stroboskopi değerlendirme formu ss. 50 51

2.7.3.3 Videolaringostroboskopi Değerlendirme Protokolü ss 49 50

2.7.3.4 Vibratuar paternleri değerlendirmenin diğer yöntemleri

* EGG

* Fotoglottografi

* Akım glottografi

* Videokimografi

* High speed link intensified dijital görüntüleme

2.8 Nörolojik değerlendirme

2.8.1 Laringeal EMG

2.9 Diagnostik ses terapisi

2.10 Psikolojik değerlendirme

(Kaynak: 4)

KAYNAKLAR

2006-01-14T14:49:00.000-08:00

Blog sitelerimde kullanılan kaynaklar:
1. Şarkı Söyleme Sanatının Öyküsü. Yalçın DAVRAN. Evrensel Müzikevi 1997.
2.
3.
4. Management of the Voice and Its Disorders. L Rammage, M Morrison, H Nichol. Singular Publishing, Canada 2001.
5. www.jaapa.com/issues/j20050801/articles/lpr0805.htm
6. Oğuz H, Tarhan E, Korkmaz M, Yılmaz U, Şafak MA, Demirci M, Özlüoğlu LN. Acoustic analysis findings in objective laryngopharyngeal reflux patients. Journal of Voice Epub. 6 January 2006.
7. Harvard University Massachusetts General Hospital Center for Laryngeal Surgery and Voice Rehabilitation, LPR and Vocal Difficulty patient information form.
8. www.saglik.gov.tr/extras/birimler/basin/sbdiyalog/07KASIM.pdf Erişim 22.07.05, 20:46

TONGUE PARESTHESIA AND DYSGEUSIA FOLLOWING OPERATIVE MICROLARYNGOSCOPY

2006-01-14T12:38:00.000-08:00

Belachew Tessema, MD; Lucian Sulica, MD; Guo-Pei Yu, MD, MPH; Roy B. Sessions, MD
Objectives: This study was performed to assess the overall incidence and duration of alterations in tongue sensation andtaste after operative microlaryngoscopy, and the relation of these symptoms to operative time.Methods: We performed a retrospective review of information regarding tongue symptoms in patients who completedstandard post-microlaryngoscopy follow-up at 1 week, 1 month, and 3 months.Results: One hundred patients (54 male and 46 female; mean age, 46 years; age range, 14 to 83 years) met the inclusioncriteria. Eighteen patients had positive findings at 1 week: 15 complained of paresthesia and 3 of dysgeusia. The symptomsdecreased over time without treatment (4% of patients at 1 month and 1% of patients at 3 months). Only 1 case ofdysgeusia persisted past 3 months. Gender was found to be a significant independent risk factor for the development ofsymptoms (odds ratio, 5.63; 95% confidence interval, 1.36 to 31.29; p = .013). Patients whose operations lasted longerthan 1 hour were almost 4 times more likely to develop tongue-related symptoms than those with an operative time lessthan 30 minutes, although these findings did not achieve statistical significance (odds ratio, 3.91; 95% confidence interval,0.62 to 30.95; p = .182).Conclusions: Alterations in tongue sensation and taste, most likely due to lingual nerve injury, are common after microlaryngoscopy,especially in female patients. They also tend to be associated with longer operative times. Although transientin nearly every case, lingual paresthesia and dysgeusia should form part of the preoperative discussion with the patient.Key Words: complication, dysgeusia, lingual nerve, microlaryngoscopy, paresthesia, tongue.
Annals of Otology, Rhinology & Laryngology 2006;115(1):18-22.