Background/Aim. A more recent method, the auditory steadystate response (ASSR), has become more and more important test method due to difference that was found in previous investigations between hearing thresholds determined by the ASSR and the pure-tone audiometry (PTA). The aim of this study was to evaluate the reliability of the ASSR in determining the frequency specific hearing thresholds by establishing a correlation between the thresholds determined by PTA, as well as to evaluate the reliability of ASSR in determining the hearing threshold with respect to the level of hearing loss and the configuration of the PTA findings. Methods. The prospective study included 46 subjects (92 ears) which were assigned to groups based on their level of hearing loss and audiometric configuration. All the subjects underwent determination of hearing thresholds by PTA and ASSR without insight into their previously obtained PTA results. Results. The overall sample differences between the ASSR and PTA thresholds were 4.1, 2.5, 4.4, and 4.2 dB at 0.5, 1, 2, and 4 kHz, respectively. A high level of correlation was achieved in groups with different configurations of PTA findings. The correlation coefficients between the hearing thresholds determined by ASSR and PTA were significant in subjects with all levels of hearing loss. The differences between hearing thresholds determined by ASSR and PTA were less than 10 dB in 85% of subjects (ranging from 4 dB for moderately severe hearing loss to 7.2 dB for normal hearing). Conclusion. The ASSR is an excellent complementary method for the determination of hearing thresholds at the 4 carrier frequencies, as well as determination of the level of hearing loss and the audiometric configuration
The aim of this study is to analyze the impact of various parameters on the course and treatment outcome in patients with laryngotracheal stenosis and recurrent stenosis. Two groups of patients were compared: Group I included 29 patients with primary stenosis, and Group II included 22 patients with recurrent stenosis. The most frequent etiological factor for the development of stenosis was prolonged endotracheal intubation (79.3:77.3%), with subglottic-tracheal (44.8:45.5%) and tracheal (48.3:36.4%) localization being the most affected. Subglottic-tracheal stenosis was more common in men. There were no significant differences between the groups in regard to the grade of lumen obstruction and the length of the resected segment. In male patients, the length of the resected stenotic segment was significantly longer. Subglottic-tracheal stenoses were longer than tracheal ones. Various surgical procedures were performed, with additional management of recurrent laryngeal nerve paralysis, if necessary. Laryngotracheal reconstruction (LTR) with costal cartilage grafting (CCG) was statistically significantly more often performed in Group II, while cricotracheal resection (CTR) was more common in Group I. The incidence of complications in Group I was 24.1%, and in Group II it was 31.8%. Satisfactory airway lumen with undisturbed breathing was achieved in 93.1% of patients in Group I, and in 95.3% in Group II. Since the success rate was similar in both groups of the patients, it could be concluded that treatment outcome depends less on the factors associated with the stenosis, and more on adequate choice of surgical procedure and surgical team know-how.
Background: Successful speech rehabilitation has a great impact on the quality of life in totally laryngectomized patients. Objectives: The aim of this paper was to compare the self-assessed voice handicap of totally laryngectomized patients with two different methods of alaryngeal speechesophageal (ES) and tracheoesophageal speech (TES). Method: The research comprised 83 totally laryngectomized, disease-free patients, split into two groups. The first group included 43 participants with successfully rehabilitated ES, and the second group included 40 participants with successfully established TES after secondary implantation of Provox 2 TM voice prosthesis. All subjects filled in the Serbian version of the Voice Handicap Index (VHI-30). The results (overall score and three VHI subscales) were analyzed and compared with those of the subjects of both groups. The impact of age in the subgroups (< 65 years old and ≥65 years old) and previous irradiation on the examined VHI values were also analyzed. Results: The median value of the overall VHI score in the participants with TES was 29.03 ± 23.479 (range: 0-97), and in the participants with ES it was 64.51 ± 21.089 (range: 19-99). The VHI scores (overall and three VHI subscales) were significantly higher in participants with ES compared to those with TES (p < 0.01), indicating a larger voice handicap. No significant difference was found in the overall VHI score and VHI subgroups in terms of age subgroups and previous irradiation (p > 0.05). Conclusions: Our data reveal a significantly higher voice handicap in participants with ES compared to the TES group, with a large interindividual variation within both groups. VHI values are not significantly different between the two age subgroups, nor are they significantly influenced by irradiation.
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