A voice assessment was performed before and after conservative voice treatment in 3 male-to-female transsexuals and in 2 nontreated transsexuals serving as control persons. The characteristics studied were voice quality, habitual speaking pitch, vocal pitch range, vocal intensity range, maximum phonation time and ‘communicative impairment’, a subjective self-estimation by the patient. Based on these parameters the Friedrich dysphonia index (DI) was calculated. The habitual speaking pitch of the 3 transsexuals who had received voice treatment became female, in contrast to that of the nontreated transsexuals, which remained in the so-called ‘indifferent pitch range’. The DI of the treated patients was close to the normal value, in contrast to the DI of controls, which continued to be pathological. Even based on this small population, study results reflected the effectiveness of voice therapy in transsexuals.
Fungal sinusitis caused by invasive fungal infections, such as Mucormycosis, occurs predominantly in an immunocompromised patient. However, invasive cranial bone mycoses are rare and are usually associated with host immunodeficiency. They are difficult to diagnose, and in many cases are fatal. Treatment consists of antifungal chemotherapy, radical surgical debridement, and control of the underlying immunological condition. We report a case of Mucormycosis in a patient with type 1 diabetes mellitus. The patient had a history of dental pathology and associated renal dysfunction. The patient was managed by extensive surgical debridement followed by amphotericin B lipid complex injection (Abelcet 5 mg/bw kg/day) as an antifungal agent. Our patient's ocular function was affected. The radical treatment and follow-up by a multidisciplinary team eliminated the mucor-related consequences, however, the patient died because of end-stage renal failure. In conclusion, type 1 diabetes may be associated with invasive fungal sinusitis.
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