J. Otorhinolaryngol. Hear. Balance Med., Volume 4, Issue 2 (December 2023) – 6 articles

Objective—The objective of this study was to systematically assess meta-analyses to determine the lacunae in the literature for PCF following laryngectomy. Methods—Bibliometric analysis were carried out on meta-analyses on PCF after total laryngectomy for laryngeal cancer in the PubMed database. Results—Twenty-four meta-analyses were considered eligible and chosen for analysis. Six meta-analyses (25%) focused on the risk factors for PCF in TL. Four meta-analyses (16.6%) focused on the role of the onlay flap. Four meta-analyses (16.6%) focused on the timing of feed initiation. Three meta-analyses (12.5%) focused on using a stapler for pharyngeal closure. Two meta-analyses focused on types of pharyngeal reconstruction. Other meta-analyses analyzed the use of salivary bypass tubes, the method of pharyngeal closure, organ preservation protocols on PCF, primary and secondary TEP, and the effect of non-surgical treatment on PCF. Conclusion—Despite plenty of published meta-analyses, there is a lack of scrutiny on certain critical aspects of PCF. Full article

Background: En block resection of squamous cell carcinoma (SCC) of the concha represents a reconstruction challenge, due to the complex topography and difficult access. Objective: The objective of the present paper is to describe the chemically assisted dissection (CADISS) of SCC originating in the auricular concha and the following reconstruction of the conchal cavity with a post-auricular island flap (PIF), taking care to minimize injury to the donor site. Methods: Twenty-six patients having a diagnosis of SCC of the auricular concha were included in the study. ‘En bloc’ removal of the tumor was accomplished, leaving the adjacent conchal cartilage attached to the tumor and using the CADISS technique to preserve the deep perichondrium. A PIF was used to repair the auricular conchal defect. Results: Flaps were normal at 10 days and at 1-month follow-up. No tumor recurrence was observed. No complications were observed. According to the SCAR scale, good aesthetic outcomes were achieved in all cases, both at the auricular concha and at the donor site. Conclusion: CADISS facilitates the complete removal of the tumor with the preservation of the surrounding normal tissues. A post-auricular island flap can be easily pulled through a post-auricular tunnel to repair the defect and the donor site can be closed primarily. Full article

Despite the evolution of hearing aids and cochlear implants, noisy environments are reportedly still an important hurdle for persons with hearing loss, especially in the process of speech recognition. The development of pre-processing algorithms and the pairing with a wireless device can bring relief to this situation, but it is still under scrutiny whether one or the other is more effective. The purpose of this study was to compare the benefits of speech recognition in a noisy environment by recipients of cochlear implants when using the pre-processing automatic algorithms or when using a wireless microphone. Twenty-nine participants were selected, aged 14 to 83, suffering from sensorineural hearing loss and recipients of cochlear implants for at least 6 months. The proprietary Cochlear Limited SCAN technology uses pre-processing algorithms to attenuate various noises; the wireless device MiniMic2 uses a 2.4 GHz connection to facilitate communications between the recipient and the signal source. Participants were asked to repeat 20 sentences randomly generated by the adaptive Italian Matrix Sentence Test, first while using the SCAN technology and then with the wireless MiniMic2. Both signal and noise were administered through a single loudspeaker set 1 m away from the subject. Significantly better results in speech recognition of noise were achieved with the wireless MiniMic2 when compared to the SCAN technology. Full article

(1) Background: Vocal fold nodules are bilateral lesions that can have an important negative impact on a person’s job performance, social interaction, and quality of life. This study aims to analyze multidimensional voice evaluation outcomes in a group of patients with bilateral vocal fold nodules who underwent voice therapy. (2) Methods: A retrospective analysis was performed in 42 patients on the following voice evaluations, before and after voice therapy: visual-perceptual (video-laryngostroboscopic evaluation), auditory-perceptual voice analysis based on the GRBAS scale, and aerodynamic voice analysis. Data were collected from January 2001 to December 2019. Data analyses were performed with non-parametric tests (Wilcoxon test) using α = 0.05. (3) Results: The patient average age was 33.6.1 ± 10 years (range 19–60), and 95.2% were female. Voice therapy was delivered by an experienced speech-language pathologist once a week, with an average of 9.8 ± 3 appointments (range 8–17). Vocal fold lesions disappeared in 40.4% of the patients after voice therapy, especially in participants receiving early voice therapy (p = 0.035). When comparing pre- and post-therapy audio-perceptual results, all parameters were improved with statistical significance (p < 0.05) except for the asthenic voice scale. Aerodynamic parameters were all improved but without statistical significance (p > 0.05); (4) Conclusions: Early timing to initiate voice therapy after the onset of symptoms or diagnosis seems to be an important factor for the success of voice therapy (absence of vocal fold nodules). Full article

Past studies have reported that there are higher sound-pressure levels for each vowel in a child’s ear canal than those in adults due to reduced volume and a shorter ear canal. Furthermore, longer vocal tracts are associated with lower formant frequencies, and vice versa. The structural differences in this regard may reflect the difference in the occlusion effect. Thus, the present study compares the sound pressure levels (SPLs) and first formant frequencies of children and adults with normal hearing and determines the best vowel stimulus to assess the occlusion effect. A repeated measures research design was utilized to investigate the best stimulus with which to measure the occlusion effect among children and adults. Group 1 included ten children, and Group 2 comprised ten adults with normal hearing. The SPLs at frequencies between 200 Hz and 1000 Hz for three uttered vowels, with steps of 100 Hz, were measured using a hearing aid analyzer. The recorded vowels were saved in a ‘.wav’ format for formant frequency analysis. Furthermore, a paired comparison method was used to identify the vowel stimulus that most effectively induced the occlusion effect. A significantly higher SPL was observed for children compared to adults for each vowel. The formant frequency F1 value was higher for children than adults for each vowel, constituting a significant finding. In the paired comparison, the occlusion effect was reported to be significantly greater with respect to the vowel /u/ among adults, while it was reported to be greater in relation to the vowel /i/ among children. The vowel /u/ was the best stimulus with which to assess the occlusion effect among adults. The vowel /i/ was the best stimulus with which to assess the occlusion effect among children. Full article

The Auditory Steady-State Response (ASSR) provides objective and ear-specific information essential for early and appropriate intervention. Test–retest reliability is essential for audiological monitoring. The test–retest reliability of the ASSR has received limited attention. Only a handful of studies found in the literature investigated the test–retest reliability of old-generation ASSR using amplitude or mixed modulated stimuli. However, to our knowledge, no published reports have specifically examined the test–retest reliability of the next-generation ASSR using Chirp family stimuli as implemented in the Interacoustics Eclipse system. This pilot study investigated (a) the test–retest reliability of air conduction (AC) ASSR thresholds across two test sessions and (b) the relationship between differences in ASSR thresholds across two sessions to the residual noise levels in normal-hearing adults. Methods: Fifteen normal-hearing adults (12 females) (30 ears) with an average age of 28 years were recruited for the study. The ASSRs were recorded using a two-channel recording montage. The automatic default stimuli and recording protocol using 90 Hz ASSR, and the accuracy method (p < 0.01) as implemented in the Eclipse system is used to measure ASSR. Results: The study demonstrated strong test–retest reliability for ASSR across frequencies (500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz). Notably, the highest reliability was observed at 500 Hz. The mean test–retest reliability of ASSR was found to be comparable to pure-tone thresholds, but the intra-subject variability is higher for ASSR compared to pure-tone thresholds. Additionally, no significant correlation was found between the difference in ASSR residual noise levels at the threshold and the difference in ASSR thresholds at all tested frequencies. Conclusion: The next-generation system demonstrated strong test–retest reliability across the frequencies examined in this pilot study. Particularly, an improvement in reliability was observed at 500 Hz compared to the old-generation ASSR. This enhancement can be attributed to the utilization of narrow-band CE-chirp stimuli, which generate large amplitude responses, and the implementation of an improved detection paradigm involving multiple harmonics spectral and phase analysis. This pilot study only enrolled adults with normal hearing, and future investigations should include a larger sample size comprising both normal-hearing and hearing-impaired individuals, as well as the pediatric population. Full article