Free-Field Hearing Test in Noise with Free Head Rotation for Evaluation of Monaural Hearing

There is a discrepancy between the hearing test results in patients with single-sided deafness (SSD) and their reported outcome measures. This is probably due to the presence of two elements in everyday situations: noise and head movements. We developed a stereo-audiometric test in noise with free head movements to evaluate movements and auditory performance in monaural and binaural conditions in normal hearing volunteers with one occluded ear. Tests were performed in the binaural condition (BIN), with the left ear (LEO) or the right ear occluded (REO). The signal was emitted by one of the seven speakers, placed every 30° in a semicircle, and the noise (cocktail party) by all speakers. Subjects turned their head freely to obtain the most comfortable listening position, then repeated 10 sentences in this position. In monaural conditions, the sums of rotations (head rotations for an optimal hearing position in degrees, random signal azimuth, 1 to 15 signal ad lib signal presentations) were higher (LEO 255 ± 212°, REO 308 ± 208° versus BIN 74 ± 76, p < 0.001, ANOVA) than those in the BIN condition and the discrimination score (out of 10) was lower than that in the BIN condition (LEO 5 ± 1, REO 7 ± 1 versus BIN 8 ± 1, respectively p < 0.001 and p < 0.05 ANOVA). In the monaural condition, total rotation and discrimination in noise were negatively correlated with difficulty (Pearson r = -0.68, p < 0.01 and -0.51, p < 0.05, respectively). Subjects' behaviors were different in optimizing their hearing in noise via head rotation. The evaluation of head movements seems to be a significant parameter in predicting the difficulty of monaural hearing in noisy environments.

Primary squamous carcinoma of the submandibular gland: A case report

The uncommon occurrence of primary squamous carcinoma of the submandibular gland makes it a challenge to diagnose and treat. Clinical as well as histopathological assessments are key elements for the diagnosis. Although no clear treatment guidelines exist, surgical excision with a neck dissection is the cornerstone of the treatment with or without adjuvant therapy. In this paper, we report a rare case of a primary squamous carcinoma in an 82-year-old lady with no history of smoking or alcohol use, who presented with a right sided cervical swelling of 3-month duration. An ultrasound guided fine needle aspiration cytology was negative, as well as a panendoscopy with systemic biopsy of the base of tongue and the homolateral palatine tonsil. In addition, a blind fine needle aspiration cytology from the mass during the panendoscopy was performed and was positive for squamous cell carcinoma. A PET scan showed hypermetabolism of the right submandibular gland with no distant lesions. Therefore, a submandibular gland excision was performed with a frozen section histopathological examination in favor of squamous cell carcinoma, therefore the intervention was completed by a selective neck dissection. High clinical suspicion should be present while dealing with this rare entity, as well as not underestimating the poor outcomes associated with it.

The French way of voice rehabilitation post total laryngectomy: current clinical practices and tendencies

BACKGROUND

Vocal rehabilitation post total laryngectomy (TL) lacks clinical guidelines, especially with the presence of multiple modalities.

OBJECTIVES

To describe the tendencies of vocal rehabilitation post TL in France and compare it with other countries. We try to identify the most practiced modalities and recognize statistically significant influencing factors.

MATERIALS AND METHODS

An electronic anonymous survey was answered by 75 ENT surgeons from France. The survey outlined the common practiced vocal rehabilitation modalities and had two versions depending on if the participant practices the tracheoesophageal speech (TES) or not.

RESULTS

96% use TES in their practice. Single modality TES and double modality TES with esophageal speech (ES) are the two most practiced modalities. 99% agreed that there is no age limit for the TES. Single modality ES was offered 92% more when more than 10 TL were performed per year (p < .05). No influencing factors found for single modality TES or double modality TES with ES (p > .05).Conclusion: In line with tendencies from other countries, the TES is the most practiced modality of vocal rehabilitation coupled or not with the ES. TES has no age limit as per our participants. The least practiced modality is the singe modality ALS.