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  • ISSN: 2379-948X
    Volume 5, Issue 2
    Research Article
    Afaq Abbasova* and Elcin Tadihan Ozkan
    Objectives: Voice therapy is one of the options for management of dysphonia. Therapy attendance affects the voice therapy outcome. The aim of this study is to analyze the demographic features of voice therapy patients in Turkey and patient's attendance to voice therapy.
    Methods: 468 dysphonic patients (279 female, 179 male), aged between 4-74 years, were included in this study. Their documents analyzed retrospectively. Patients' age, gender, professions, diagnosis, and attendance to therapy were analyzed.
    Results: The patients were divided into two age groups: 4-18 years were in the pediatric group, and 19-74 years were in the adult group. The most prominent professions among the patients of the adult group were teacher, homemakers and students. The predominant diagnoses among children who were directed to voice therapy were vocal nodules, mutational falsetto and functional dysphonia. The predominant diagnoses among the adults were vocal nodules, functional dysphonia, and vocal fold paralysis. 50,21% of the total patient underwent voice therapy. 27,14% of the patients who were referred for voice therapy didn't begin therapy after the first assessment by a speech and language therapist. 54 patients had attended to 3-6 therapy sessions, whereas 52 patients had attended to only 1 or 2 therapy sessions, and because of several reasons they dropped out from the voice therapy programme.
    Conclusions: Adults were directed to voice therapy more frequently than children. The frequent diagnoses of patients who were referred for voice therapy were nodules and functional dysphonia. A high percentage of nonattendance to voice therapy sessions was observed.
    Ching-Chi Hsiang, Chien-Mi Chang, Chih-Hua Chen, and Yueh-Juen Hwu*
    Dysphagia is a common health risk for the elderly. Due to physical and / or cognitive disabilities, many long-term care service users are dependent on their caregivers' skills and knowledge in many aspects of their lives. This study investigated the effects of an 1-day dysphagia training delivered to long-term care workers, and eighty workers took part in the study. Two questionnaires were completed by each participant: one immediately before and one after training delivery. The questionnaires measured the knowledge, attitude, and skills of long-term care workers for dysphagia. The findings indicated a significant increase in knowledge and skill scores. The study found that dysphagia training was effective at increasing staff's knowledge and skills regarding dysphagia detection and management. It is recommended that this study should be replicated with a control group, and improved feasibility could be achieved through long-time follow up.
    Review Article
    Goubran Eskander*
    Background: The diagnosis and management of Idiopathic Sudden Sensorineural Hearing Loss (ISSNHL) has been always controversial and is likely to remain so. As being a disease of unknown/putative causes and unpredictable outcome, standard documentation/ definitions/ plan of management are needed. A large array of empiric treatments has been used and serious side effects can occur from such empiric treatment(s). The lack of one or more uniformly accepted treatment(s)/investigation(s) potentially increases the cost of management/ risks on patients. Even the presence of clinical guidelines doesn't mean that all physicians are aware of it, and its implementation may be difficult, impractical or not feasible. Therefore, it is important for each hospital/ local department to provide clinicians with evidence-based local protocol/ agreement in evaluating patients with ISSNHL, with particular emphasis on management.
    Aim: The aim is to develop protocol for management of ISSNHL using evidence-based medicine (EBM) and available clinical guidelines. This protocol/policy is intended for local hospitals/ departments to aid diagnose or manage patients who present with ISSNHL. This protocol follows available EBM and published guidelines, and at the same time will be cost-effective with reasonable risk-benefit. The protocol is aimed to be a one paper sheet, to be clear and easy to follow on display panels in clinics/emergency departments or on intranet to be viewed or printed easily
    Conclusions: This protocol represents a good practice with high levels of clinical effectiveness in use. It is feasible, applicable and in line with recent EBM and guidelines. It can be used by local hospitals/ departments in actual practice to provide safe and high standard care. Though it is intended to represent the local care for patients' management through easy clear steps that every physician can follow, as it is important to standardize the management of ISSHL in a local hospital/ department, but it can mainly be a nucleus upon which further audit/research can proceed to build up more EBM and measure its practicality.
    Stave Salgado Karen Vanessa*
    Dysphagia is any disruption to the swallow sequence that results in compromise to the safety, efficiency, or adequacy of nutritional intake. Pediatric dysphagia has focused largely on a number of specific populations at risk for swallowing difficulties, such as children with cerebral palsy, acquired/traumatic brain injury, other neuromuscular disorders, craniofacial malformations, airway malformations, congenital cardiac disease, and gastrointestinal disease.
    The gastroesophageal disorders that cause dysphagia and swallowing/feeding difficulties, such as gastroesophageal gastroesophageal reflux disease, eosinophilic esophagitis and achalasia need an early diagnosis because they can compromise quality of life and produce complications at the patients.
    Short Communication
    Nic Beckmann, Aaron Smith, Stephen Larson, Vikrum Thimmappa, and Anthony Sheyn*
    Outcome Objectives:
    1. Identify if there is a correlation between I'M SLEEPY score screening and AHI on sleep study results in patient's presenting for non-sleep disorder breathing complaints.
    2. Recognize which patient's based on screening to obtain polysomnography.
    Introduction: Pediatric Obstructive Sleep Apnea (OSA) is a common problem that can have severe complications if not recognized and treated. Determining which patients have primary snoring compared to OSA can be a challenge in the primary care setting. The I'M SLEEPY questionnaire has been used in a sleep study setting and has been proposed to be a fast useful screening tool in a larger setting. We use it as a screening mechanism in a pediatric otolaryngology clinic.
    Methods: A retrospective study of 376 patients who presented to a pediatric otolaryngology clinic was performed. These patients underwent screening with the I'M SLEEPY questionnaire and the results were evaluated if they underwent polysomnography. We used a score of 5 or more as a positive screening survey. We compared the data obtained of the patients who were presenting with sleep disordered breathing problems versus the patients that did not have a sleep disorder breathing related complaint.
    Results: 376 patients were identified that completed the I'M SLEEPY questionnaire. Of those, 86 completed a polysomnography. 52 of the patients presented with a sleep disorder breathing related complaint compared to 34 that presented with a non-sleep disorder breathing complaint. 21 in the non-sleep disorder breathing group were identified with at least mild obstructive sleep apnea based on an AHI greater than 1, of those 17 had a positive screen on the I'M SLEEPY screening study.
    Conclusion: Screening pediatric patients with this survey may help identify undiagnosed sleep apnea. Additional patients are needed to determine whether screening should be implemented in pediatric otolaryngology offices.
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