Synopsis: The prevalence of ETD was investigated in 295 babies aged three to 24 months who were diagnosed with OSA. Of these, 31.9 percent met the criteria for ETD, with a breakdown of 66 percent males and 34 percent females. An analysis of OSA severity in patients with ETD showed 41.5 percent mild, 39.4 percent moderate and 19.1 percent severe, with a similar distribution in general OSA. A total of 30 patients (31.9 percent) required two or more myringotomy and ventilation tube placement (MT) procedures, with 135 MT procedures overall. The authors noted that additional MT procedures following nonsurgical interventions occurred more frequently (54.5 percent) than after surgical interventions (34.8 percent). The nonsurgical interventions occurred at an earlier average age (15.5 months) than the surgical interventions (20.3 months).
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May 2012Bottom line: The prevalence of ETD in patients with OSA (31.9 percent) is significantly higher than in the general pediatric population (4 to 7 percent); however, the efficacy of surgical treatment is not clear from this study.
Reference: Robison JG, Wilson C, Otteson TD, et al. Increased Eustachian tube dysfunction in infants with obstructive sleep apnea. Laryngoscope. 2012;122(5):1170-1177.
—Reviewed by Sue Pondrom
Risk Factors for Spasmodic Dysphonia
Which risk factors are uniquely associated with spasmodic dysphonia, compared with other voice disorders?
Background: Symptoms for spasmodic dysphonia, believed to be a focal dystonia of the larynx, typically begin in the fifth decade of life and remain chronic thereafter. There are approximately 50,000 individuals with spasmodic dysphonia in the U.S. No cure exists, and treatment options are limited to botox chemodenervation, laryngeal nerve avulsion or denervation-reinnervation surgical procedures.
Study design: Case-control epidemiology study.
Setting: Department of Communication Sciences and Disorders, Division of Otolaryngology-Head and Neck Surgery, University of Utah; University of Utah Voice Disorders Clinic and Surgical Center, Salt Lake City; Department of Health Science, Brigham Young University, Provo, Utah; Department of Speech-Language Pathology, University of New Mexico Hospitals, Albuquerque.
Synopsis: A questionnaire was administered to 150 patients with spasmodic dysphonia and 136 patients with other structural, neurological and functional voice disorders. Several factors were uniquely associated with spasmodic dysphonia: 1) a personal history of cervical dystonia, sinus and throat illnesses, mumps, rubella, dust exposure and frequent volunteer voice use; 2) a family history of voice disorders; 3) an immediate family history of vocal tremor and meningitis and 4) an extended family history of head and neck tremor, ocular disease and meningitis. Vocal tremor coexisted with spasmodic dysphonia in 29 percent of cases. The authors found no association between spasmodic dysphonia and psychogenic or behavioral issues. The diverse control group and lack of conventional epidemiologic sampling procures and statistical analyses made it difficult to establish risk factors.