OBJECTIVE:To assess the effectiveness of three vestibular rehabilitation protocols in patients with chronic unilateral vestibular hypofunction.STUDY DESIGN:Prospective randomized trial.SETTING:Audiology-neurootology laboratory in a general public hospital.PATIENTS:Eighty-one patients were randomly allocated into three groups: adaptation exercises (AEs), habituation exercises (HEs), and combined exercises (AE-HEs).INTERVENTIONS:Each patient completed an 8-week vestibular rehabilitation program with exercise, depending on their allocation group.MAIN OUTCOME MEASURES:Evaluations performed at baseline, 4 weeks, and 8 weeks with (a) Functional Gait Assessment (FGA), (b) Mini-BESTest, (c) Vestibular Rehabilitation Benefit Questionnaire, and (d) Dizziness Handicap Inventory.RESULTS:FGA and Mini-BESTest scores showed significant improvement between the baseline and 8-week scores in all groups (p < 0.001), except for the FGA score in the HE group. The AE-HE group showed better scores for all measurements at 4 weeks and had significantly better FGA and Mini-BESTest scores than the AE group and better FGA scores than the HE group. The Vestibular Rehabilitation Benefit Questionnaire and Dizziness Handicap Inventory scores in the AE-HE group were significantly better (p ≤ 0.001) than those in the HE group at 8 weeks.CONCLUSIONS:The AE-HE group showed faster improvement and significantly better outcomes for static balance, dynamic postural stability, and self-perceived disability than the single-exercise protocols in chronic unilateral vestibular hypofunction.

Objective: The investigation of supervised vestibular rehabilitation treatment role for individuals with dizziness and imbalance due to peripheral, unilateral vestibular disorders. Databases Reviewed: Cochrane, PubMed, and Physiotherapy Evidence Database (PEDro) were utilized to identify relevant studies. Methods: The key search terms used were "Vestibular Rehabilitation and Unilateral Vestibular Hypofunction," "Vestibular Rehabilitation and Unilateral Vestibular Loss," and "Vestibular Rehabilitation and Supervision." A manual search was performed by exploring the references of included articles to identify studies not captured through the computer-based searches. The quality of the studies was assessed according to the PEDro scale. Inclusion criteria were: 1) studies with patients, aged from 18 to 80 years, with acute or chronic dizziness and disequilibrium due to unilateral vestibular dysfunction, 2) randomized control trials (RCTs), 3) studies comparing supervised vestibular rehabilitation program with an unsupervised vestibular rehabilitation program or home-based training or standard care or placebo, and 4) articles written in the English language. Studies reporting cases of vertigo and imbalance due to possible recurrent pathologies, acute benign paroxysmal positional vertigo, or central neurological/orthopedic deficits, were excluded. Results: A total of 448 articles were retrieved from the systematic database search strategy. Five of them were included in the systematic review after full-text analysis, plus one more after manual searching of their references. All studies involved supervised vestibular rehabilitation treatment programs compared with unsupervised home training, the performance of daily activities and, standard care. Based on PEDro's scoring system, one study rated as high-quality RCT, three studies were considered of fair quality and one scored as low-quality RCT. Conclusions: Although most RCTs report better outcomes with a supervised vestibular rehabilitation treatment program regarding the emotional status, dizziness, and balance improvement, this systematic review failed to provide a strong evidence that supervision is superior to unsupervised protocols in patients with UNH. The self-reported subjective measures used by the included RCTs represent a serious limitation of their results.

The present study aimed to investigate the effects of oral steroids on olfactory disturbances in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). This is a prospective randomized non-blinded study. Selected CRSwNP patients (n = 140), with hyposmia, were devided into two groups; group A received a 7-day course of oral steroids with a 12-weeks course of nasal steroids and douching; group B received a 12-weeks course of nasal steroids and douching. Assessment included Sniffin’ Sticks scores, visual analogue scale score for olfaction and discomfort (VASsmell, VASdis), the Sinonasal Outcome Test-22, Greek-version (SNOT22-Gr) and the endoscopic appearance (EAS). The main objective was to compare the olfactory effect of the different therapy in group A and group B, at 2, 12 and 24 weeks. Accessory objectives included the comparison of EAS, VASdis and SNOT22-Gr between groups, the evaluation of the therapeutic outcome duration, and, the investigation of potential correlation between the evaluated parameters. The 2-weeks evaluation showed a significant statistical difference (P < 0.001) for all parameters except VASdis. Olfactory outcomes (Sniffin’ Sticks and VASsmell scale scores) were found significantly better in group A at the 24-weeks evaluation (P < 0.001). Within groups, the therapeutic result remained stable between the 12-weeks and 24-weeks evaluation (P > 0.05). Sniffin’ Sticks score was strongly correlated at 12-weeks evaluation with EAS (rho = 0.58, P < 0.001). Our results suggest that a combination treatment of oral and nasal steroids in well-selected patients with CRSwNP may result in early olfaction restoration with a possible long-term effect.

Objective To assess whether children with sleep-disordered breathing (SDB) symptom severity above a certain level, measured by a validated questionnaire, improve after adenotonsillectomy (AT) compared to no intervention. Methods Children with snoring and tonsillar hypertrophy (4 to 10-years old), who were candidates for AT, were randomly assigned to two evaluation sequences (baseline and 3-month follow-up): (a) evaluation immediately before AT and at 3 months postoperatively (AT group); or (b) evaluation at the initial visit and at the end of the usual 3-month waiting period for surgery (control group). Outcomes were (a) Pediatric Sleep Questionnaire sleep-related breathing disorder scale (PSQ-SRBD); (b) modified Epworth Sleepiness Scale (mESS); and (c) proportion of subjects achieving PSQ-SRBD <0.33 (low-risk for apnea-hypopnea index >= 5/h) if they had score >= 0.33 at baseline. Results Sixty-eight children were assigned to the AT and 72 to the control group and two-thirds of them had PSQ-SRBD >= 0.33. The AT group experienced significantly larger improvement between follow-up and baseline than controls (between-group difference [95% CI] for PSQ-SRBD: -0.31 [-0.35 to -0.27]; and mESS: -2.76 [-3.63 to -1.90]; P < .001 for both). Children with baseline PSQ-SRBD >= 0.33 in the AT group had an eight-times higher probability of achieving PSQ-SRBD <0.33 at follow-up than controls with similar baseline score (risk ratio [95% CI]: 8.33 [3.92-17.54]; P < .001). Conclusion Among children with snoring, tonsillar hypertrophy, and clinical indications for AT, those with preoperative PSQ-SRBD score >= 0.33 show measurable clinical benefit postoperatively.

OBJECTIVES: We evaluated the efficacy of adenotonsillectomy (T/A) in children with sleep-disordered breathing (SDB) in a controlled study using oximetry. We hypothesized that children with SDB and abnormal nocturnal oximetry in a community setting will have improved hypoxemia indices after T/A. METHODS: Children with snoring and tonsillar hypertrophy (4–10 years old) who were candidates for T/A were randomly assigned to 2 oximetry sequences (baseline and 3-month follow-up): (1) oximetry immediately before T/A and at the 3-month follow-up, which occurred postoperatively (T/A group); or (2) oximetry at the initial visit and at the end of the usual 3-month waiting period for surgery (control group). Outcomes were (1) proportion of subjects with McGill oximetry score (MOS) >1 at baseline acquiring MOS of 1 at follow-up and (2) proportion of subjects achieving oxygen desaturation (≥3%) of hemoglobin index (ODI3) <2 episodes per hour at follow-up if they had ODI3 ≥3.5 episodes per hour at baseline. RESULTS: One hundred and forty children had quality oximetry tracings. Twelve of 17 (70.6%) children with MOS >1 in the T/A group and 10 of 21 (47.6%) children with MOS >1 in the control group had MOS of 1 at follow-up (P = .14). More subjects in the T/A than in the control group achieved ODI3 <2 episodes per hour at follow-up (14 of 32 [43.8%] vs 2 of 38 [5.3%]; P < .001). Three children with elevated ODI3 were treated to prevent persistently abnormal ODI3 in 1 child at follow-up. CONCLUSIONS: An ODI3 ≥3.5 episodes per hour in nocturnal oximetry is related to increased resolution rate of nocturnal hypoxemia after T/A for SDB compared with no intervention.

OBJECTIVEComparison of the efficacy of Transitory Evoked Otoacoustic Emissions (TEOAEs) and Distortion Product Otoacoustic Emissions (DPOAEs) in a neonatal hearing screening protocol, based on a three-stage strategy.METHODSIn the first stage, a hearing screening using both evoked emissions was conducted in 3,480 neonates from March 2006 through January 2012. Both TEOAEs and DPOAEs were recorded. Neonates, who did not undergo the test before being discharged, were examined within 30 days at a scheduled appointment. Follow-up of the referred newborns (second-stage screening) was performed as an outpatient re-screening, within a month. The third-stage evaluation, i.e., the diagnostic testing, included a clinical otolaryngological examination, high-frequency tympanometry at 1,000 Hz and Auditory Brainstem Response (ABR) measurements.RESULTSA total of 3,480 (97%) newborns (n =1,765 males) out of 3,595 infants were enrolled in the study. In the first-stage evaluation, 8.9 % of the infants were referred according to TEOAEs, while the percentage of the referred infants for DPΟΑΕs was 25.7 %. At this initial assessment stage, the specificity of TEOAES and DPOAEs were determined as 92% and 75%, while positive predictive values (PPV) were 3.8 % and 1.3 %, respectively. In the second stage of evaluation, the specificity of TEOAES and DPOAEs were 86 % and 76 %, while the PPV increased to 18 % and 15 %, respectively.CONCLUSIONSWith a lower follow-up rate, TEOAEs testing was significantly easier to perform and more reliable compared to the DPOAEs test. Hippokratia 2016, 20(2): 104-109.

Objectives. This study aims to investigate early voice changes after total thyroidectomy, to assess the improved parameters in intermediate postoperative intervals, to evaluate the effect of age on voice after thyroidectomy, and to determine the correlation between the objective and the subjective method outcomes.Study Design. This is a prospective, nonrandomized study.Materials and Methods. One hundred ninety-one participants, divided into two age groups, underwent three full voice assessments (preoperatively and 1 and 8 weeks after thyroidectomy) by means of videostroboscopy, perceptual evaluation, acoustic analysis, aerodynamic evaluation, and a self-evaluation questionnaire. Two control groups enrolled in the study: (1) patients with an indication of neck surgery not related to laryngeal nerve injury risk or strap muscle dissection and (2) patients with an indication of a non-neck surgery.Results. No statistically significant difference was found in any voice parameter, between preoperative and 1-week postoperative assessment regarding the control groups. A statistically significant difference was found between preoperative evaluation and 1 week after thyroidectomy for the total study population, as well as for the = 40 years' age subgroup for all parameters evaluated except for shimmer. The <40 years' age subgroup showed a statistically significant difference in pitch, maximum phonation time, and grade, roughness, breathiness, asthenia, and strain (GRBAS) score between preoperative evaluation and 1 week after thyroidectomy. None of the parameters showed a statistical significant difference in the <40 years' age subgroup at 8 weeks' evaluation. The Voice Handicap Index (VHI) score correlated significantly with the GRBAS score preoperatively and postoperatively at 1 and 8 weeks' evaluations. Furthermore, VHI correlated significantly with pitch a week postoperatively. GRBAS scores showed significant correlation not only with VHI but also with acoustic parameters including pitch, shimmer, and noise-to-harmonic ratio 1 and 8 weeks after thyroidectomy.Conclusions. Objective voice changes are common in the majority of the thyroidectomized patients in the early postoperative period. Our results revealed that these changes are related to thyroidectomy per se. Older patients (= 40 years of age) show acoustic and aerodynamic changes 8 weeks postoperatively, although they report no voice abnormalities and their perceptual evaluation is similar to the preoperative one.

Objective: Report a rare case of a thyroid papillary carcinoma situated within a branchial cleft cyst.Case presentation: A 40-year-old male was referred to our department for a lateral neck mass assessment.Physical examination revealed a solitary palpable, painless, moveable neck mass.Assessment included complete nasal, pharynx and larynx endoscopy, neck computed tomography, and fine needle aspiration biopsy.Treatment was surgical excision of the neck mass.Histopathology confirmed a branchial cleft cyst with papillary thyroid carcinoma growth at a site.A neck and thyroid ultrasound showed presence of thyroid gland nodules (one of which with micro calcifications).Thyroid fine needle aspiration biopsy performed, was high suspicious for malignancy (BETHESDA V).Patient underwent total thyroidectomy and histopathology revealed papillary thyroid carcinoma.Conclusion: Although rarely, it is possible to face an unexpected malignancy within a clinically benign neck lesion.A thorough diagnostic work-up enables early identification of aforementioned potential malignancy.A diagnostic dilemma that arises in such cases is between primary or metastatic disease and a thyroid carcinoma arising from ectopic thyroid tissue.

The objective of the analytic observational study was to present air-pollen counting program results for a 5-year period. Airborne pollens and fungi collection, from both urban and sub-urban areas, were obtained using a special Burkard pollen trap installed on the roof of Chania General Hospital. Aeroallergen concentration measurement was made in a standardized way with fixation of the material collected and then counting using an optical microscope. Annual and total circulating pollen and fungi counts for the study period are presented. In the year 2014, the highest total annual count was recorded, while 2013 was the year with the lowest one. Months with the highest average concentrations were June for the years 2010 and 2011 (1291 and 1114.6 grains/m3, respectively) and May for the consecutive 3 years 2012–2014 (1120, 890 and 1353.1 g/m3, respectively). Peak periods for circulating aeroallergens were April–June. Trees pollen accounted for the majority of circulating aeroallergens (615.9 and 677.1 g/m3 during peak periods in the years 2012 and 2014), while fungi accounted for the majority of circulating aeroallergens (818.5, 729.4, 890.7 spores/m3), during the peak periods in the years 2010, 2011 and 2013. Variability in peak airborne allergen periods could be partly explained by the differences in climatic conditions during the study period.

Polysomnography is the gold standard for evaluating the efficacy of adenotonsillectomy (AT) in children with obstructive sleep-disordered breathing (SDB), but it is not available in all settings. We hypothesized that AT is associated with reduction in the proportion of children with oxygenation abnormalities in nocturnal oximetry (Ox). Methods: 4-10 year-old children with SDB (snoring >3 nights/week) and tonsillar size >2+ were randomized to AT immediately after recruitment (AT group) or to observation (no AT group). The AT group had Ox preoperatively and 3 months postoperatively; the no AT group had Ox upon recruitment and 3 months later. Main outcomes were: i) change in proportion of children with McGill oximetry score =1 (normal); ii) proportion of subjects who achieved a desaturation index-ODI (≥3% SpO2 drop) of <2/h at 3 months (follow-up), if they had ODI ≥3.5/h at baseline. Results: Preliminary analysis of data from the first 161 participants is presented. Pairs of Ox with quality recordings were obtained in 114 subjects (AT group: n=57; no AT group: n=57). The frequency of normal McGill score increased from 68.4% in the first Ox (pre-op) to 89.5% in the second Ox (post-op) in the AT group and from 75.4% to 84.2% in the no AT group (P>0.05). In the initial Ox, 52.6% of children in the AT group (pre-op) and 49.1% in the no AT group had ODI ≥3.5/h. In the follow-up Ox, the abnormal ODI normalized (<2/h) in 46.7% of cases in the AT group and 3.6% in the no AT group (P<0.01). Two children with ODI≥3.5 had to be treated for one child to achieve a normal ODI (<2/h). Conclusion: ODI ≥3.5/h is a satisfactory measure of the efficacy of AT as treatment for SDB.

The aim of the present study was the investigation of age influenced changes in ocular motility testing in healthy subjects. Two hundred and fifty subjects between 18 and 70 years old were enrolled in a prospective study. Study population was divided in 5 groups of 50 subjects each (group A: 18-30 years old, group B: 31-40 years old, group C: 41-50 years old, group D: 51-60 years old and group E: 61-70 years old). Ocular motility was recorded by video-oculography and age related normative data were obtained with respect to: a) gain and slow phase velocity of smooth pursuit tracking, b) latency, velocity and accuracy of saccade eye movements and c) gain and slow phase velocity of optokinetic eye movements. The influence of age on all parameters was examined by one-way ANOVA. A statistically significant difference was found in all parameters analyzed for smooth pursuit test, saccade eye movements and optokinetic eye movements in between groups. In conclusion, aging influences the majority of the parameters in ocular motility testing, carried out by means of video-oculography. Elderly healthy subjects showed a deterioration of performance in all parameters of the eye tracking tested. Age must be taken into account during interpretation of the eye tracking tests, especially in patients with central nervous system lesions.

Objectives/Hypothesis Alternaria and Cladosporium are the most important outdoor moulds. The aim of this study was to present fungal spore monitoring data, investigate the relationship of fungal counts with climate conditions, and to explore the clinical significance of Alternaria and Cladosporium species monitoring in allergic rhinitis (AR). Study Design Analytic observational study. Methods A 7‐day volumetric trap was used to collect circulating Alternaria and Cladosporium fungi. Sixty‐nine AR patients were studied and recorded their symptoms by Total 5 Symptoms Score (T5SS). Sensitization prevalence to fungi species was detected by skin prick tests. Monitoring data were correlated to climate conditions and patients symptoms score. Results Alternaria and Cladosporium were detected throughout the calendar year in ranges of 0 to 217 spores/m 3 and 6.5 to 1,600 spores/m 3 per day, respectively. Highest daily concentrations of both fungi were detected during the summer (73.9 ± 34.4 spores/m 3 for Alternaria and 595.8 ± 288.0 spores/m 3 for Cladosporium ) and lowest during the winter (2.4 ± 3.0 spores/m 3 for Alternaria and 24.3 ± 15.7 spores/m 3 for Cladosporium ). Both were positively correlated to mean daily temperature and negatively to relative humidity (all P < 0.001). Clinically, a strong significant correlation between T5SS and airborne fungi levels, both for Alternaria (r = 0.822, P = 0.001) and Cladosporium (r = 0.787, P = 0.002) species was observed. Conclusions We found Cladosporium to be the most frequently detected airborne mould, whereas Alternaria was the most prevalent with regard to sensitization rate. Patients' symptoms score was significantly correlated to spore concentrations. Both fungi were clearly affected by climate factors, such as temperature and relative humidity. These findings are important in AR management. Level of Evidence N/A. Laryngoscope , 126:E51–E56, 2016

BACKGROUND:Chronic rhinosinusitis (CRS) is a disease with increasing incidence, characterized by persistent symptoms and negative impact on patient`s quality of life. Nasal inspiratory peak flow (NIPF) and acoustic rhinometry (AR) were studied and compared as assessment tools for CRS with or without nasal polyps (NP), as well as, in follow up monitoring of conservative medical treatment.OBJECTIVES:Seventy-eight patients were prospectively studied. Objective assessment included NIPF and AR at baseline and at 4 and 8 weeks after onset medical treatment. Measurements were studied in correlation with Sinonasal Outcome Test-22 (SNOT-22) questionnaire, Visual Analogue Scale (VAS) and endoscopic appearance score (EAS).RESULTS:Both NIPF and AR improved significantly, after medical treatment. NIPF score reflected CRS symptoms` improvement according to SNOT-22 total score at the end of treatment protocol, showing moderate to strong correlation with nasal obstruction VAS grading during the treatment period. AR measures were associated with EAS in all sets of examinations and correlated moderately with VAS scoring at 8 weeks.CONCLUSION:NIPF and AR were proven to be promising methods for objective evaluation and monitoring of nasal obstruction based on different aspects of nasal physiology in patients with CRS.

Myoepithelial carcinomas exhibit a wide spectrum of cytomorphologic features and diverse clinical outcomes. As a result of their morphologic heterogeneity, they can be confused easily with many tumours. Herein we report the morphological features of myoepithelial carcinoma in a 74-year-old female clinically presenting with a parotid mass. FNAB revealed hypercellular, three-dimensional clusters with considerable overlapping and crowding of pleomorphic neoplastic cells which consisted predominantly of spindle cells, with oval to elongated to spindle shaped nuclei showing considerable variation in size. The excised tumour was solid, with cells arranged in trabeculae, nests and cords. Tumour cells were mixed epithelioid and spindle with eosinophilic or clear cytoplasm, with eccentric nuclei and prominent nuclei. Neoplastic cells were found in blood vessels, in the skin and facial nerve. Tumour cells were immunopositive for PAS, PAS-D, S-100 protein, GFAP, P63, CK5/ CK6, CK7, and CK14. This case illustrates that cytological features in FNAB generally reflect the histology. FNAB was able to confirm the diagnosis and guide patient management.

BACKGROUND:Arachnoid cysts most frequently occur in the middle cranial fossa and when they are symptomatic, patients present with central nervous symptoms. Nevertheless, a large proportion of arachnoid cysts are incidentally diagnosed during neuroimaging in cases with nonspecific symptoms.REPORT OF CASES:The cases of two males with middle cranial fossa arachnoid cysts with nonspecific inner ear symptoms were retrospectively reviewed. The first patient presented with mild headache, nausea, vertigo, unsteadiness, and tinnitus on the left ear while the second patient's main complaint was left sided tinnitus. Both patients (initially managed for peripheral disorders) underwent a thorough clinical and electrophysiological evaluation. Because of the patients' persistent clinical symptoms, and indications of CNS disorder in the first case, neuroimaging by brain MRI was performed revealing a middle cranial fossa arachnoid cyst in both patients.CONCLUSION:Occasionally, patients with arachnoid cysts may present with mild, atypical or intermittent and irrelevant symptoms which can mislead diagnosis. Otorhinolaryngologists should be aware of the fact that atypical, recurrent or intermittent symptoms may masquerade a CNS disorder. Hippokratia 2014; 18 (2):168-171.

Background: Chronic rhinosinusitis (CRS) with or without nasal polyps is a frequent and significant health problem. The 22-item Sinonasal Outcome Test (SNOT-22) is a valid, disease-specific health status instrument translated into several languages. The translation into Greek has been considered essential for the individual assessment of the patients' symptoms and a reliable tool for quality of life evaluation. Methods: Our study included 40 patients with CRS without nasal polyps and 40 healthy individuals as control group recruited from the ENT Allergy and Endoscopy Clinic of Chania General Hospital. Assessment included full ENT examination and nasal endoscopy. In the study, we compared the patients' examination and reexamination results with the results of the control group, and thus estimated test-retest reliability, internal consistency (determined by Cronbach's alpha) and validity. Results: The statistical significance level calculated by the paired t test was p < 0.05 for all questions, which proves the questionnaire's consistency. The kappa value was estimated for each symptom, with an average value of 0.94. Cronbach's alpha was 0.934 in the test and 0.856 in the retest. The p value was <0.05 between both the control group and the test group and between the control group and the retest group. Conclusion: Our study certifies the existence of a valid, reproducible Greek version of SNOT-22, which overcomes limitations of use, allows to answer the questionnaire in Greek, and thus makes it highly recommended for Greek clinicians.

Purpose of the Study: To examine the clinical value of subjective evaluations of obstructive sleep apnea syndrome (OSAS) in correlation with syndrome severity as diagnosed with polysomnography. Procedures: 210 patients with mild to severe OSAS were assessed. Objective evaluation included polysomnography. Subjective assessment included full ENT examination, neck circumference (NC) plus body mass index measurements, Mueller maneuver and Epworth Symptom Scale (ESS). Results: The presence of lateral pharyngeal wall movement, abnormal ESS scoring and male gender can be considered independent risk factors for the prediction of moderate/severe OSAS (p < 0.05). Increased NC can also be considered a clinical risk factor related to male gender and lateral pharyngeal wall movement (p = 0.05). Conclusions: Subjective OSAS assessment, including evaluation of lateral pharyngeal wall movement, ESS scoring and NC measurement can safely predict, mainly in males, OSAS severity, as diagnosed with polysomnography. Message of the Paper: Subjective assessment from the ENT point of view should raise high suspicion towards the early diagnosis of moderate/severe OSAS.

Objectives/Hypothesis: Adenoidectomy and tonsillectomy (TE) is the standard treatment for obstructive sleep-disordered breathing (SDB) in children with adenotonsillar hypertrophy. Tonsilloplasty (TP) is a new surgical technique that includes partial TE. The purpose of this study was to assess the short-and long-term outcomes of TP compared to TE.Study Design: A comparison study.Methods: Children with SDB and tonsillar hypertrophy underwent TP or TE. The two groups were compared regarding immediate postoperative course and long-term effects.Results: Fifty-one children (age, 6.3 +/- 2.5 years) underwent TE, and 50 children (age, 5.9 +/- 2.1 years) had TP. The TP group had significantly less intraoperative bleeding compared to the TE group (25.6 +/- 8.2 vs. 38.3 +/- 12.3 mL, P < .001). Subjects with TP were pain free earlier than children with TE (4.5 +/- 0.4 vs. 7.7 +/- 0.4 days, P < .001) and returned to a normal diet sooner (3.8 +/- 0.2 vs. 7.1 +/- 0.3 days, P < .001). By the 3rd to 4th postoperative night, upper airway obstruction was relieved in all participants. Six years postoperatively, 48 of 51 children in the TE group and 43 of 50 children in the TP group participated in a telephone survey. No significant differences were found between the two groups regarding the frequency of recurrent snoring (30.2% in TP vs. 25% in TE), apneas (4.7% vs. 0%), and upper airway infections per year (P > .05).Conclusions: TP is an alternative surgical method for treatment of SDB related to tonsillar hypertrophy with favorable postoperative course and comparable long-term results.

OBJECTIVES/HYPOTHESIS:The objective was to study the role of the Greek version of Voice Handicap Index (VHI) in comparison with Voice Symptom Scale (VoiSS) in terms of measuring voice surgery outcome in patients with benign laryngeal lesions.STUDY DESIGN:Nonrandomized prospective.METHODS:Forty-six patients operated for benign laryngeal lesions were enrolled in the present study. All patients were assessed according to the European Laryngological Society guidelines. In terms of self-evaluation, patients answered the Greek versions of both VHI and VoiSS, preoperatively and 6 weeks postoperatively, and the results were statistically analyzed.RESULTS:The strongest correlation was observed between the functional subscale of VHI and the impairment subscale of VoiSS, as well as, between the emotional subscales of both VHI and VoiSS, pre- and postoperatively. A statistically significant change in subscale and total scores was found. VHI and VoiSS subscales and total scores correlated with the stroboscopic and aerodynamic measurements in a variable manner. Perceptual measurements, as well as shimmer and harmonic-to-noise ratio showed significant correlation with both VHI and VoiSS subscale and total scores postoperatively.CONCLUSION:VHI and VoiSS are considered useful tools in evaluating voice surgery outcome, in the Greek language.