Biomedical subjects

Nora Siupsinskiene

Publications and source records attributed to Nora Siupsinskiene.

6 recordsLinked to original sources

PubMed2006

Frozen versus fresh reconstituted botox for laryngeal dystonia.

OBJECTIVES: To compare the efficacy and side effects of frozen versus fresh reconstituted botulinum toxin type A (BTX-A) in the treatment of laryngeal dystonia. STUDY DESIGN AND SETTING: Prospective open-label crossover study; 43 adult patients with adductor spasmodic dysphonia were randomly treated with fresh or refrozen reconstituted BTX-A at a private voice center. Treatment outcomes were assessed by duration of action and self-rated satisfaction (7 point Likert scale). Side effects of breathiness and dysphagia for liquids were assessed as well. RESULTS: There was no statistically significant difference in the duration of action (mean, 16.2 +/- 8.5 vs 16.0 +/- 7.6 weeks) and self-rated satisfaction of the treatment (median, 6.0 vs 6.0 points). The side effects were similar for both BTX-A injection types. In addition, there were no instances of infection for refrozen injections. CONCLUSIONS: BTX-A may be safely used after being reconstituted and frozen or refrozen without a significant loss of effectiveness or additional side effects. In our experience, the period of freezing was on 2 occasions for up to 8 weeks. SIGNIFICANCE: Refrozen BTX-A may be a cost-effective use of an expensive drug. EBM RATING: B-2b.

Adult↗

PubMed2006

Thyroid surgery: changing patterns of practice.

OBJECTIVE: The practice of thyroidectomy has evolved over the past 10 years with the introduction of minimally invasive surgery, laryngeal nerve monitoring, and outpatient surgery. We sought to investigate corresponding trends in the disciplines performing thyroid surgery. METHODS AND MATERIALS: The authors conducted a nonrandomized, case-controlled comparison of surgical volumes and systematic analysis of publication volumes. Two surrogates for the proportion of thyroidectomies being performed by otolaryngologists-head and neck surgeons (OHNS) and general surgeons (GS) were chosen: 1) the operative case logs of graduates from American training programs in OHNS and GS from 1995 through 2004 were compared; and 2) the number of scientific articles published relating to thyroid surgery were systematically queried for two timeframes (1990-1994 and 2000-2004). RESULTS: There was a gradual increase in the mean number of thyroidectomies performed by GS residents from 13.2 in 1995 to 18.2 in 2004. During the same timeframe, the mean number of thyroidectomies performed by OHNS residents more than doubled from 15.0 to 33.5. The number of American GS thyroid publications from 1990 to 1994 was 79, compared with 98 in the period 2000 to 2004, representing a 24% increase. During the same timeframe, the number of American OHNS articles increased from 14 to 49 (a 250% increase). The relative proportion of thyroid publications authored by American otolaryngologists more than doubled from 15.1% to 33.3% (P = .0017). CONCLUSIONS: A clear trend is emerging in the pattern of thyroid surgery in that a growing proportion of publications are being authored by otolaryngologists compared with general surgeons, and the average number of procedures performed by graduating chief residents is now 84% higher in otolaryngology compared with general surgery.

Case-Control Studies↗

PubMed2003

Quantitative analysis of professionally trained versus untrained voices.

The aim of this study was to compare healthy trained and untrained voices as well as healthy and dysphonic trained voices in adults using combined voice range profile and aerodynamic tests, to define the normal range limiting values of quantitative voice parameters and to select the most informative quantitative voice parameters for separation between healthy and dysphonic trained voices. Three groups of persons were evaluated. One hundred eighty six healthy volunteers were divided into two groups according to voice training: non-professional speakers group consisted of 106 untrained voices persons (36 males and 70 females) and professional speakers group--of 80 trained voices persons (21 males and 59 females). Clinical group consisted of 103 dysphonic professional speakers (23 males and 80 females) with various voice disorders. Eighteen quantitative voice parameters from combined voice range profile (VRP) test were analyzed: 8 of voice range profile, 8 of speaking voice, overall vocal dysfunction degree and coefficient of sound, and aerodynamic maximum phonation time. Analysis showed that healthy professional speakers demonstrated expanded vocal abilities in comparison to healthy non-professional speakers. Quantitative voice range profile parameters- pitch range, high frequency limit, area of high frequencies and coefficient of sound differed significantly between healthy professional and non-professional voices, and were more informative than speaking voice or aerodynamic parameters in showing the voice training. Logistic stepwise regression revealed that VRP area in high frequencies was sufficient to discriminate between healthy and dysphonic professional speakers for male subjects (overall discrimination accuracy--81.8%) and combination of three quantitative parameters (VRP high frequency limit, maximum voice intensity and slope of speaking curve) for female subjects (overall model discrimination accuracy--75.4%). We concluded that quantitative voice assessment with selected parameters might be useful for evaluation of voice education for healthy professional speakers as well as for detection of vocal dysfunction and evaluation of rehabilitation effect in dysphonic professionals.

Adolescent↗

PubMed2003

Diagnostic test with omeprazole in patients with posterior laryngitis.

The aim of the study was to evaluate the merit of empiric omeprazole therapy in patients with suspected laryngopharyngeal reflux (LPR), to determine the optimal dose and duration of diagnostic test, to compare the diagnostic value of upper gastrointestinal (GI) endoscopy and omeprazole test (OT). One hundred out-patients with posterior laryngitis and more than one atypical symptom of LPR, aged 14-68 years were treated with omeprazole for 4 weeks (clinical group). According to received omeprazole dose (20 mg, 40 mg, > 40 mg), three clinical subgroups were selected. Twenty patients treated only with life style modifications and diet composed dietary group. At the entry to the study, a symptom questionnaire (5 laryngeal and 3 esophageal scored from 0 to 3 points), well being in general (W-B(VAS) on 100-mm VAS scale), videolaryngoscopy, upper endoscopy, and voice assessment (4 voice range profile parameters and overall vocal dysfunction degree (VDD)) were completed. Total symptom index (TSI) was calculated multiplying sum of symptoms severity score by number of presented symptoms. Normal values of efficacy parameters were obtained from 113 healthy voice subjects (control group). Patients were evaluated twice during the treatment: after 1-2 weeks and after 4-5 weeks. Patients were confirmed as responders, if TSI improved at least 50%, and patients were satisfied with results. According to our data, the 1st control assessment showed significant improvement on symptoms, laryngoscopy scores, VDD, and W-B(VAS) only for clinical group patients (p<0.05). Responders rate also was advantageous for the clinical group patients in comparison to the dietary group (36.0% vs. 15%). The second control assessment showed significantly better results for the clinical group patients in comparison to the 1st (p<0.05 2nd vs. the 1st). Sixty five percent of them (65/100) were classified as responders (p<0.05). The better results were in patients receiving omeprazole more than 20 mg daily. Erosive esophagitis during upper GI endoscopy was found for 21.0% (21/100) clinical group patients, 18 of them were responders to omeprazole 4-week test (accuracy of OT with regard to confirmed diagnosis with upper endoscopy was 85.7%). At week 4, efficacy parameters were not in normal range. We concluded that short-term treatment with omeprazole might be useful in confirming the clinically based diagnosis of laryngopharyngeal reflux.

Adolescent↗

PubMed2002

[Phonatory characteristics following different endolaryngeal microsurgical techniques in Reinke's disease].

The aim of the study was to compare different surgical techniques in treatment of Reinke's edema according to subjective and quantitative changes of voice characteristics. We evaluated 62 surgically treated patients from 34 to 68 years (mean 47.7 years) with Reinke's edema. Two endolaryngeal microsurgical methods were used: classical as mechanical stripping of the mucosa-Ist, mechanical stripping group (n = 30), and removal of fluid through aspiration with preservation of vocal cord medial edges mucosa-IInd, preserving mucosa group (n = 32). Clinical voice assessment was composed of laryngoscopy, subjective voice evaluation (GRBAS hoarseness scale, visual analogue scale of voice quality, and pitch) and quantitative voice evaluation (seven quantitative voice parameters obtained from voice range profile (VRP) and registering of maximum phonation time). Patients were evaluated twice--before operation and at mean 23.8 days after. Postoperative follow-up data was registered from 57 patients: 28 from Ist and 29 from IInd groups. According to our data the positive dynamics for all voice parameters was observed in both patients' groups. Surgical approach with preservation of vocal cord medial edges mucosa on overall benefit after operation according to the voice quality is statistically significantly better compared to classical operation technique (chi 2 = 8.9, p = 0.029). While comparing these two approaches statistically significant differences were found for subjective voice parameters--grades of hoarseness and roughness, and for quantitative VRP parameters: pitch range, maximum-minimum intensity range, total voice area, and overall vocal dysfunction degree. The mean values of most voice parameters in early postsurgery period significantly differed from normal. Clinical voice assessment may be useful for evaluation of surgical treatment efficacy as well as for comparison of surgical techniques.

Adult↗

PubMed2002

[Importance of voice quality evaluation in the assessment of treatment outcome after endolaryngeal microsurgery].

The aim of the study was to compare subjective and quantitative voice characteristics changes after endolaryngeal microsurgery with respect to different postoperative follow-up term. We evaluated 80 surgically-treated patients aged 14-81 years (mean 42.6+/-13.8 years) with benign vocal cord (VC) lesions (polyps, n=37; cysts, n=16; Reinke's edema, n=18; papilomata, n=9). Patients were evaluated three times - before operation, less than two weeks (mean 1.0+/-0.4) following the operation and more than two weeks (mean 6.5+/-3.9) following the operation. Control group consisted of 122 healthy voice patients. Subjective voice evaluation composed of experts assessment (GRBAS hoarseness scale, visual analogue scale (VAS) of voice quality) and patients self-evaluation (VAS, voice handicap index, and the impression of what repercussions the voice problem has on professional life and emotions). Seven quantitative voice parameters obtained from voice range profile, laryngostroboscopy and registering of maximum phonation time were analyzed as well as overall vocal dysfunction degree (VDD). The data of second postoperative examination were statistically significantly better compared to the first postoperative follow-up (p<0.001). During the first postoperative examination the subjectively healthy voice (G=0) was found for 13.8% (11), quantitatively (VDD=0) for 22.5% (18) of patients, during the second - 63.8% (51) and 53.8% (43). The best results were for patients with vocal cords polyps. The complex voice assessment may be useful for evaluation of voice function recovery and efficacy of surgical treatment.

Adolescent↗