Search

The aim of our study was to assess the outcome of treatment of horizontal canal benign paroxysmal positional vertigo and to analyze the influence of the different prognostic factors on treatment failure. Fifty-nine patients with horizontal canal benign paroxysmal positional vertigo were included in the study. They were divided into two groups according to the treatment protocol, randomly. The first group, after treatment with the barbecue maneuver or inverted Gufoni, depending on the nystagmus form, was instructed to sleep on the side with weaker nystagmus, and the second group did not. In the first group, 88.9% of patients were cured and 91.3% in the second one. There was no significant difference between the two groups. Migraine and the apogeotropic form of nystagmus had a significant effect on treatment outcome, while other variables had no effect.

Introduction: Tinnitus, or ringing in the ears, represents an abnormal perception of sound in the ears or head without an appropriate external sound source. Today, it is known that tinnitus is not a single disease but rather a group of different disorders with various underlying mechanisms, hence requiring different types of treatment. Tinnitus lacks visible signs of illness and does not endanger life, but in many ways affects the quality of life and causes suffering. Aim: The aims of this study were: to use questionnaires to indicate the relationship between tinnitus and quality of life, to identify which areas of daily life are most affected by the presence of tinnitus, and to determine whether there is a significant difference between genders in terms of the impact of tinnitus on quality of life. Material and Methods: The study included 80 adult patients aged 18 to 82 years. Inclusion criteria for patients in the study were: tinnitus in one or both ears or in the head, tinnitus persisting continuously for 6 months or longer, and older than 18 years. Exclusion criteria for the study are patients who experience auditory hallucinations in the form of music and speech. Otologic diagnostic methods were used, including ear, nose, and throat (ENT) examination, pure tone audiometry, and tympanometry with acoustic reflex testing. Patients completed two questionnaires: a specific questionnaire for tinnitus, the Tinnitus Handicap Inventory, and a general questionnaire for assessing quality of life, the Nottingham Health Profile. Results: The prevalence of tinnitus increases with age, up to 65 years, and thereafter either remains independent of aging or decreases. The majority of participants had sensorineural hearing loss ranging from moderate to severe, predominantly affecting high frequencies, and descending. There are statistically significant positive correlations between audiometric parameters and THI scores for all frequencies except for 4000 Hz, both in the left and right ears. Conclusion: By using questionnaires as instruments to assess quality of life and the severity of tinnitus, this study has shown a negative impact of tinnitus on quality of life. We found that the duration of tinnitus affects its severity.

Smartphones and tablets are part of everyday family life. Experts who work with children or deal with various aspects of early childhood development warn of the resulting harmful consequences. It is also feared that research on the impact of the use of smartphones and tablets on children's development cannot keep up with rapid technological development. Bearing these facts in mind, in this research we tried to evaluate the quality of speech, sensorimotor development and socio-emotional behavior in children in the most sensitive period of their growth, preschool age. The research sample consisted of 40 participants, 28 boys and 12 girls, aged 5 to 6 years. Only children whose parents declared that their child spends more than three hours a day in front of the screen were included in the sample. The research used an adapted test for assessing the articulation abilities of children, the Global Articulation Test and the Scale for assessing the psychophysiological abilities of children from 0 to 7 years of age. The results of this research show that there are differences in the quality of speech in preschool children. Statistically significant differences in sensorimotor development and socioemotional behavior in preschool children were obtained by applying one-factor multivariate ANOVA. Knowledge and understanding of the harmful effects of screens on the functioning and development of children in the immediate environment is essential for taking measures to control screen exposure by parents and educators in order to prevent further regressions in the development of speech, language, sensorimotor and socio-emotional maturity and thereby stimulate optimal early development.

Frequent use of psychoactive drugs, alcohol and tobacco can lead to pathological changes in the vocal cords. The aim of this study is to analyze the connection between the consumption of psychoactive substances and disturbances in the quality of the voice by reviewing the previous literature. Voice disorders in users of psychoactive substances occur over time, due to the appearance of organic changes in the vocal apparatus. Marijuana smoke causes irritation of the mucous membrane of the larynx, which causes hoarseness and hoarseness in the voice. The effect of electronic cigarettes on voice quality is milder compared to the effect of conventional cigarettes. The results of this study also show that drug users have lower results in the domain of social functioning compared to alcohol and tobacco users. The findings of this study suggest that users of psychoactive substances have respiratory disorders and worse lung function, changes in vocal folds, disturbance of auditory and perceptual parameters of voice quality and worse quality of life. Additional implications suggest the necessary help and support of speech therapists in educating users of psychoactive substances about the ways of their use and their connection with voice disorders and quality of life as a whole.

Swallowing disorders can occur at any age, although they occur more often in old age when the physiology of swallowing changes due to aging. Oropharyngeal dysphagia is a very common clinical condition affecting 13% of the total population over 65 years of age and 51% of institutionalized older people. Given that oropharyngeal dysphagia can lead to increased morbidity and mortality in the elderly, it is necessary to prevent the occurrence of dysphagia in this population group as much as possible. In relation to this, the paper aims to provide insight into contemporary research into the etiology, pathophysiology, and symptomatology of oropharyngeal dysphagia in the elderly. In this review study, the electronic databases of Google Scholar Advanced Search and the Consortium of Serbian Libraries for Unified Procurement - KoBSON were searched. The following keywords and phrases were used in the search: swallowing, dysphagia, oropharyngeal dysphagia, aging, age and dysphagia, etiology of oropharyngeal dysphagia, the clinical picture of oropharyngeal dysphagia, pathophysiology of oropharyngeal dysphagia. This systematic review and meta-analysis of papers showed significant progress in the effective diagnostic approach of oropharyngeal dysphagia during the last years but also a significant lack of knowledge about adequate modifications of drugs applied during the treatment of patients with dysphagia. A good understanding of the etiology, pathophysiology, and symptomatology of oropharyngeal dysphagia would eliminate the harmful effects of pharmacological substances on the function of swallowing, given that the elderly, on the advice of a doctor, use them daily.

The readiness to start school includes the emotional and social maturity of the child. In order for a child to master the demands of the school program as easily as possible, a certain harmony is needed in the development of his abilities. The ability of sensory perception and the ability to integrate sensory stimuli specifically determine the development of reading and writing skills. The aim of this study is to analyze the ability to read and write in hypersensitive and hyposensitive types of sensory integration disorders, with special reference to the analysis of individualization measures in the work with these students in the school system. Disorder of sensory integration is expressed in two basic forms: increased sensitivity (hypersensitivity) and decreased sensitivity (hyposensitivity). In the school system, both forms of sensory integration disorders dominate. Hypersensitivity is manifested by rapid mental fatigue compared to other children. These children have difficulty reading and writing at the same time. They can read a word in many different ways without realizing it. Compared to the hypersensitive child who seems inert, the hyposensitive child is in constant motion, craving additional sensory stimuli in the classroom. These children have great problems with reading and writing figures and symbols such as tables, geometric shapes and musical symbols. Adjusting the teaching material for these children means increasing the font and font color before reading, dividing large-scale tasks into smaller units, using different types of writing pens, constantly emphasizing important units in the lesson, providing a summary of the lesson at the end of the lesson, and occasionally checking the legibility of the handwriting. In this way, students are provided with easier visual, auditory and tactile processing, and therefore more successful writing, reading and understanding of the read material. Thus, a student with sensory processing disorder can achieve academic success, but it is necessary to adapt the curriculum to the appropriate level of sensations.

In order to examine the differences in people suffering from depression (EG, N=18) compared to the healthy controls (CG1, N=24) and people with the diagnosed psychogenic voice disorder (CG2, N=9), nine acoustic features of voice were assessed among the total of 51 participants using the MDVP software programme ("Kay Elemetrics" Corp., model 4300). Nine acoustic parameters were analysed on the basis of the sustained phonation of the vowel /a/. The results revealed that the mean values of all acoustic parameters differed in the EG compared to both the CG1 and CG2 as follows: the parameters which indicate frequency variability (Jitt, PPQ), amplitude variability (Shim, vAm, APQ) and noise and tremor parameters (NHR, VTI) were higher; only the parameters of fundamental frequency (F0) and soft index phonation (SPI) were lower (F0 compared to CG1, and SPI compared to CG1 and CG2). Only the PPQ parameter was not significant. vAm and APQ had the highest discriminant value for depression. The acoustic features of voice, analysed in this study with regard to the sustained phonation of a vowel, were different and discriminant in the EG compared to CG1 and CG2. In voice analysis, the parameters vAm and APQ could potentially be the markers indicative of depression. The results of this research point to the importance of the voice, that is, its acoustic indicators, in recognizing depression. Important parameters that could help create a programme for the automatic recognition of depression are those from the domain of voice intensity variation.

Introduction:In addition to the characteristic clinical picture of respiratory infection, patients with COVID-19 can also be diagnosed with oral manifestations. Aim: The aim of this study was to review current literature for the prevalence of changes in the oral cavity i.e., the presence of oral symptoms in patients with COVID-19, in order to indicate that oral manifestations may occur due to viral infection with SARS-CoV-2. Methods: Important information relevant to the study was obtained by searching the available electronic PubMed and Google Scholar database. Results: Oral lesions were found in different locations in patients with COVID-19: tongue mucosa (dorsum and lateral sides of the tongue), buccal mucosa, hard and soft palate, inner lip and gingiva. The most common were ulcerations in different parts of the oral cavity. It is still unclear whether oral lesions in SARS-CoV-2 virus infection were a consequence of the primary effect of the virus itself or a secondary manifestation of the infection. The high presence of angiotensin-converting enzyme 2 in oral epithelial cells of the tongue and salivary glands indicates that the oral cavity may be particularly susceptible to SARS-CoV-2 infection. Taste disorder is the most common oral symptom in patients with COVID-19. Conclusion: Oral lesions, xerostomia, taste disorders can occur in patients diagnosed with COVID-19. Therefore, a comprehensive intraoral examination is necessary in order to determine changes in the oral cavity and apply proper treatment.

Introduction. Over the last two decades the intratympanic perfusion of corticosteroids has been used as a minimally invasive surgical therapy of Meniere’s disease. According to experimental studies the antiinflammatory, immunoprotective, antioxidant and neuroprotective role of the locally perfused corticosteroids was noticed in the inner ear structures. The recovery of action potentials in the cells of the Corti organ was confirmed as well as a decreased expression of aquaporine-1, a glycoprotein responsible for labyrinth hydrops and N and K ions derangement. Objective. The study showed results of intratympanic perfusion therapy with dexamethasone in patients with retractable Meniere’s disease who are resistant to conservative treatment. Methods. Single doses of 4 mg/ml dexamethasone were given intratympanically in 19 patients with retractable Meniere’s disease. Six single successive doses of dexamethasone were administered in the posteroinferior quadrant of the tympanic membrane. Follow-up of the patients was conducted by using a clinical questionnaire a month after completed perfusion series as well as on every third month up to one year. Results. One month after completed first course of perfusions, in 78% of patients, vertigo problems completely ceased or were markedly reduced. The recovery of hearing function was recorded in 68% and marked tinnitus reduction in 84% of patients. After a year of follow-up, in 63% of patients the reduction of vertigo persisted, while hearing function was satisfactory in 52%. Tinitus reduction was present in 73% of patients. Conclusion. Intratympanic perfusion of dexamethasone in patients with Meniere’s disease is a minimally invasive therapeutic method that contributes to the reduction of the intensity of vertigo recurrent attacks, decrease of the intensity of tinnitus and improvement of the average hearing threshold. Patients with chronic diseases and Meniere’s disease who are contraindicted for systemic administration of cortocosteroids (hypertension, diabetes, glaucoma, peptic ulcer, etc.) have an additional therapeutic option by dexamethasone intratympanic perfusion.

Background/Aim. Benign paroxysmal positional vertigo is one of the most frequent peripheral vestibular system disorders. The aim of this study was to examine the efficacy of the Epley maneuver in treating benign paroxysmal positional vertigo of the posterior semicircular canal (p- BPPV) and to discover possible causes of failure. Methods. This prospective study included 75 patients. In all the cases medical history showed and the positioning Dix-Hallpike test confirmed the diagnosis of p-BPPV. We also performed clinical ENT examination, searching for spontaneous nystagmus, vestibulospinal tests, caloric test, and audiometry. All the patients were treated by the modified Epley canalith repositioning maneuver. The patients were followed up at the intervals of seven and, fourteen days, and one, tree, and six months and one year. The maneuver was repeated if vertigo and nystagmus on control positioning test persisted. The transition from positive into negative Dix Hallpike test after one or two Epley maneuver was considered as success in treatment. Results. After the initial Epley maneuver the recovery rate was 90.7%, and after the second 96%. In three (4%) patients with secondary p-BPPV, symptoms did not cease even after the second repositioning maneuver. The etiology of p-BPPV had a significant effect on the maneuver’s success rate (p < 0.01), whereas duration of symptoms, age and gender had no effect (p > 0.05). After a successful treatment 11 (14.66%) patients had recurrent attack of BPPV during the first year. Conclusion. The Epley maneuver is very successful repositioning procedure in treating p- BPPV. The patients with idiopathic form p-BPPV showed higher success rate with Epley maneuver than those with secondary p-BPPV.

Background⁄Aim. A school teacher's occupation is one of the most vocal demanding professions. Vocal tiredness affects acoustic characteristics of voice, leads to the change in acoustic quality during vocal production. The aim of this study was to examine the influence of vocal tiredness on voice acoustic characteristics of school teachers. Methods. The study included 36 school teachers (16 male and 20 female) of 27-58 years of age. Vocal tiredness was evaluated by analyzing acoustic parameters of voice, using computerized laboratory “Kay Elemetrics”. The voices were recorded before the first class on the beginning of a working week and after the last class at the end of a working week. Signal, noise and tremor parameters were processed. In their analysis the methods of descriptive statistics, as well as the analytical statistics (Student's t-test for paired samples, χ2 test, Mann Whitney U-test and Pearson’s correlation coefficient) were applied. Results. The obtained results showed statistically significant differences in average values of parameters as a consequence of the vocal tiredness (p < 0.01), while gender, age and being smoker or not, did not have a significant effect on voice acoustic characteristics in this group of examinees (p > 0.05). Conclusion. The results of the study suggest a casual relationship between vocal tiredness and voice quality in vocal professionals.

Introduction. The hearing apparatus is one of the most important factors related to the development of oral communication. Thus, hearing disorders and deafness lead to severe handicap. Hearing impairment in adults cause verbal communication disorders that influence psychical, emotional and social functioning. Nowadays, there is a noticeable world tendency towards improving hard of hearing person’s quality of life. Objective. Objective was to assess the association between hearing impairment and health-related quality of life. Methods. A hundred adults with billateral hearing impairment underwent hearing examination and answered the Hering Handicap Inventory for the Elderly-Screening (HHIE-S, Ventry and Weinstein), specific for hearing impairment. Results. Almost half of all participants (44%) had a moderate hearing loss, and 36% had a mild loss. Infrequently, participants had a severe degree of hearing loss (13%) and deafness (7%). Self reported hearing handicap revealed significant emotional, social and situational dysfunctions (χ2=40.960; df=1; p

Background/Aim. Prevention of the consequences of hearing loss can be accomplished by early hearing screening of the cochlear function in newborus, but also with continuous hearing screening in the early childhood. The aim of this study was to investigate the reliability and feasibility of otoacoustic emissions (OAE) in hearing screening in children, evaluate the frequency and type of hearing loss and determine etiological factors of these losses. Methods. In the study, 133 children, aged 2 to 7.5 years, were tested on both ears with transient evoked otoacoustic emissions (TEOAE) and distortionproduct otoacoustic emissions (DPOAE). Before screening tests all children had undergone otoscopic examination. If children had not passed either or both hearing screening tests and/or abnormal otoscopic findings in at least one ear, audiological evaluation was scheduled to confirm or exclude hearing loss. Results. Eighty-five percent of children passed the hearing and otoscopic screening bilaterally. For additional audiologic tests 15% of children were referred. Agreement between otoscopic examination and screening tests was very good (agreement for TEOAE 95%, for DPOAE 93%). The results showed that normal tympanograms were very likely to be associated with normal screening tests. Sensitivity of TEOAE test was 94.12%, specificity 78.95%, while DPOAE sensitivity was 87.50% and specificity 75%. Hearing loss was found in 6.76% of the cases, conductive in 6.01% and sensorineural in 0.75%. Conductive hearing loss was a consequence of chronic otitis media with effusion in 25% of the cases, and a consequence of adhesive process in the middle ear in 8.33% of cases. Sensorineural hearing loss was a consequence of using ototoxic medications. Conclusion. TEOAE and/or DPOAE tests are reliable, noninvasive, and feasible methods for hearing screening in childhood.

Over the last several decades, cochlear implantation has been fully proven as the treatment for profound hearing losses. The direct electrical stimulation of the spiral ganglion hair cells through the electrode inserted in the cochlear scala tympani is the essence of the cochlear implant (CI) functioning. Modern technological development has introduced unexpected technical quality possibilities of the device itself, as well as coding strategies, which further enable improved patients' rehabilitation results. Nevertheless, in spite of cochlear implantation becoming a routine surgical procedure, which has been changing lives of thousands of profoundly deaf adults and children, it has possible complications. Though rare, these complications could lead to severe, even fatal consequences. Bacterial meningitis represents one of the most severe postoperative complications. In this article, our five-year experience with cochlear implantation is shown, compared to other, much bigger, experiences. Despite severity and a potentially fatal outcome of meningitis, it has rarely been seen, and the precise connection between surgical procedure and this complication is not yet clear. Do cochlear implants increase the risk of bacterial meningitis? Are deafness-associated factors predisposing the bacterial meningitis occurrence, independently from the implant? These are the questions that the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the CI surgeons have been facing, as well as manufacturers and patients with their families.

Introduction. There are subjective and objective ways to examine the effects of vocal therapy in voice disorders. The most precise and objective check-up is the use of computer voice analysis. Objective. The aim of the research was to perform a detailed analysis of acoustic structure of the vowel A before and after voice treatment in patients with vocal fold nodules in order to obtain objective verification of the vocal rehabilitation success. Methods. We examined 30 female patients, aged 34.6±6.69 years, with vocal fold nodules. Acoustic parameters of voice were compared with the control group consisting of 21 subjects without voice pathology. In all persons the vowel A was recorded and analyzed before and after a month of vocal therapy. The success of the vocal therapy was tracked using computer analysis of vocal structure. Signal, noise and tremor parameters were processed. Results. Of the analyzed vowel A parameters: STD, PER, JITA, JITT, RAP, vFO, ShdB, SHIM, APQ, VTI, SPI, F0, NHR, FTRI, eleven improved (p0.05). Conclusion. Based on the obtained results it was concluded that vocal therapy gave satisfactory results, but that it should be continually applied until full stabilization of the voice.

Introduction: Prevalence of sensorineural hearing loss is 1-3 per 1,000 newborns. Transient evoked otoacoustic emission (TEOAE) and automated auditory brain stem responses (AABR) are most frequently used methods in newborn hearing screening programmes. Objective. The aim of this study was to examine hearing function in newborns with and without risk factors for hearing loss. We investigated accuracy and feasibility of two automated technologies: transient otoacoustic emissions (TEOAE) and auditory brain stem response (AABR) in early detection of hearing loss. Method. In prospective study, 907 newborns were tested on both ears with transient evoked otoacoustic emissions (TEOAE). If results were "refer", we performed automated brain stem response (AABR). Two stage screening protocols were used with two screening technologies (TEOAE, AABR). Results. Results showed screening pass of 86.3% of the newborns in the first protocol and 99.3% in the second. Six (0.7%) newborns had positive screening results for hearing loss. They were referred for additional audolologic tests (otoacoustic emissions, tympanometry, and auditory brain stem response) to confirm or exclude hearing loss. Audiologic examination was performed up to the third month of life. We confirmed unilateral sensorineural hearing loss in two babies. Average test time per ear was 21.3±19.4 s for TEOAE and 135.3±67.9 s for AABR. Conclusion TEOAE, AABR tests are confidential, noninvasive and feasible methods and can help to detect hearing impairment.

Juvenile nasopharyngeal angiofibroma is an infrequent epi-pharyngeal tumor necessitating particular diagnostic and therapeutic procedures in comparison to other benign epipharyngeal tumors due to its expansive growth tendency. Our retrospective study is aimed at presenting clinical casuistry of the tumor in order to evaluate modern diagnostic and therapeutic possibilities. The study included 13 male patients, aged 13-24 years, who were hospitalized, diagnostically assessed and surgically treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia over the period 1990 - June 2001. The following parameters were analyzed: sex, age groups, preoperative symptoms of the disease, diagnostic methods, embolization, local tumor spreading, number and time of tumor relapses and surgical approach.

Chronic inflammation of the middle ear is the most frequent cause of otogenic complications. Meningitis is the most frequent otogenic intracranial complication, followed by otogenic brain abscesses, while other complications are significantly less frequent. The study is aimed at presenting clinical casuistry of otogenic brain abscesses consequential to chronic suppurative otitis in order to evaluate modern diagnostic and therapeutic possibilities. The study was retrospective and included the patients treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery of the Clinical Centre of Serbia diagnosed with otogenic brain abscess during a five-year period (1996-2000). A total of 9 patients (male to female ratio 8:1), aged 16-68 years, were assessed. The following parameters were analyzed: sex, age groups, place of living, occupation number of hospitalizations, diagnostic procedures, symptoms and clinical signs of otogenic complications, other otogenic complications associated with brain abscess, endocranial localization of otogenic abscess therapeutic procedures (oto-surgical treatment) and intraoperative otological findings. In our group of patients, otogenic brain abscesses were significantly more frequent in male patients in their forties, with median age of 33.5 years. As for the place of living, the patients from the provinces were more frequent, while with respect to their level of education, those with elementary or high school degrees were predominant. The inflammatory process most frequently spread into the endocranium through direct destruction of the bone walls of the middle ear. Diagnostic procedures included history, clinical otorhinolaryngological examination audiological and vestibulological assessment, neurological ophthalmolog-ic and radiographie examinations (CT, MRI). CT is the most reliable diagnostic tool enabling localization of the change, timing of surgical treatment and monitoring of surgical success. Presence of other otogenic complications associated with brain abscess was evidenced in six of our patients. Cerebral localization of abscess was more frequent (7). Four patients underwent previous oto-surgical treatment. The treatment included primary neurosurgical approach (radical extirpation or abscess drainage), followed by radical oto-surgical treatment after improvement of the patient's general condition.

Extraosseous Ewing's sarcoma is extremely rare in the soft tissues of the neck, especially in the sternocleidomastoid muscle. It usually manifests clinically as a rapidly growing mass that shows great potential for local spread. The aim of this paper is to present a rare case of еxtraosseous Ewing's sarcoma in the sternocleidomastoid muscle. To the best of our knowledge, this is the first case of extraskeletal Ewing's sarcoma at this location. The patient was admitted to our clinic because of a neck tumefaction. The computerized tomography finding showed a tumor mass, most of which was in the V region of the neck, measuring 40 × 27 × 35 mm. Pathohistological and immunohistochemical findings showed that it was Ewing's sarcoma. Unfortunately, the patient passed away nine months after the initial diagnosis. Extraosseous Ewing sarcoma is a rare, fast-growing malignant tumor manifesting histomorphological similarities to bone Ewing's sarcoma. Most reports state that extraosseous Ewing sarcoma has a worse prognosis than skeletal. Extraosseous Ewing sarcoma should be borne in mind in the differential diagnosis of soft tissue tumors of the neck., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2024 Sasa Jakovljevic et al.)

COVID-19 infection is associated with a variety of neurological manifestations. Since the inner ear is vulnerable to viruses, sensorineural hearing loss (SNHL) has been reported to occur following SARS-CoV-2 infection. We present here two cases of profound SNHL following SARS-CoV-2 infection. Pure-tone audiograms confirmed profound SNHL. The tympanogram and Auditory Brainstem Responses showed no abnormal symptoms. MRIs and CTs identified some changes but no significant anatomical nor physiological manifestations explaining the obvious cause for hearing loss. High doses of oral corticosteroids with additional conservative therapy were given with no therapeutic response, and therefore, cochlear implant surgery was performed. One case was bilaterally treated, and the other one received an implantation on one side. Both surgeries were carried out without intra- nor postoperative complications. Interestingly, in both cases, advanced fibrotic tissue was found during surgery. Both cases reported successful rehabilitation and are satisfied with their new sound perception following cochlear implantation.

Microgreens are young plants of various vegetables, medicinal and aromatic plants, cereals and edible wild plants that were first associated with nouvelle cuisine as decoration in dishes due to their attractive appearance and strong flavor. Recently, they have become more sought after in the market due to their high nutritional value. This is due to the growing interest of consumers in a healthy lifestyle that includes a varied diet with emphasis on fresh, functional foods. Nowadays, commercial production of microgreens is shifting to modern hydroponic systems due to their numerous advantages, such as accelerated plant growth and biomass production, earlier harvesting, and more production cycles that positively affect yield and chemical composition. Therefore, the aim of this study was to determine the content of specialized metabolites and antioxidant capacity of hydroponically grown alfalfa (Medicago sativa) cv. 'Kangaroo', yellow beet (Beta vulgaris var. conditiva) cv. 'Yellow Lady', red cabbage (Brassica oleracea L. var. rubra) cv. 'Red Carpet', and fennel (Foeniculum vulgare) cv. 'Aganarpo' microgreens. The highest content of total phenols (408.03 mg GAE/100 g fw), flavonoids (214.47 mg GAE/100 g fw), non-flavonoids (193.56 mg GAE/100 g fw) and ascorbic acid (74.94 mg/100 g fw) was found in fennel microgreens. The highest content of all analyzed chlorophyll pigments (Chl&#95;a 0.536 mg/g fw, Chl&#95;b 0.248 mg/g fw, and TCh 0.785 mg/g fw) was found in alfalfa microgreens. However, in addition to alfalfa, high levels of chlorophyll a (0.528 mg/g fw), total chlorophyll (0.713 mg/g fw) and the highest level of total carotenoids (0.196 mg/g fw) were also detected in fennel microgreens. The results suggest that microgreens grown on perlite in floating hydroponics have high nutritional potential as a functional food important for human health and therefore could be recommended for daily diet.

Objectives: Malignant (necrotizing) otitis externa (MOE) is an aggressive form of skin inflammation of the external ear with a tendency to spread infection to the temporal bone. The study aimed to evaluate a causal relationship between treatment responses and clinical features in patients with MOE., Materials and Methods: In a retrospective, descriptive section study, the database was analyzed between January 2008 and December 2018 in our department, all patients with diagnosed MOE were identified., Results: A total of 30 patients were evaluated, of which 27 men and 3 women. The youngest patient was 52 years old while he was eldest 88 years, (mean-71 years old). As the most common comorbidity, diabetes mellitus was found in 23 (76%) subjects. Median duration of symptoms was about 3 months. The most common isolated pathogen was Pseudomonas aeruginosa (47%). Patients with facial nerve palsy and erosion of temporal bone find on computerized tomography affect prolonged stationary treatment (Mean, SD 29.2±8.5 and 26,7±11.6 days), while 80% of patients with facial nerve palsy had recurrence of disease (p=0.005) with mean duration of clinical remission of 60±17.3 days. Overall length of treatment is also increased in the presence of comorbidities as well as in patients with cranial nerve involvement., Conclusion: Patients with cranial nerve involvement, erosion of temporal bone and presence of comorbidities affect prolonged treatment and adverse prognosis. Early diagnosis and initiation of aggressive therapy are essential for stopping the further spread of the disease and prevention of serious complications.

Objective: The aim of the study was to assess the effect of endolaryngeal phonomicrosurgery (EPM) and voice therapy in patients with vocal fold polyps using perceptual and acoustic analysis before and after both therapies., Methods: The acoustic tests and perceptual evaluation of voice were carried out on 41 female patients with vocal fold polyp before and after EPM and voice therapy. Both therapy strategies were performed. Used acoustic parameters were Jitter percent (Jitt), pitch perturbation quotient (PPQ), shimmer percent (Shim), amplitude perturbation quotient (APQ), fundamental frequency variation (vF0), noise-to-harmonic ratio (NHR), Voice Turbulence Index (VTI). For perceptual evaluation, GRB scale was used., Results: Results indicated higher values of investigated parameters in patients' group than in the control group (P < 0.01). Good correlation between the perceptual hoarseness factors of GRB scale and objective acoustic voice parameters were observed. All analyzed acoustic parameters improved after the phonomicrosurgery and voice therapy and tend to approach to values of the control group. For Jitt percent, Shim percent, vF0, VTI, and NHR, there were statistically significant differences. Perceptual voice evaluation revealed statistically significantly (P < 0.01) decreased rating of G (grade), R (rough) and B (breathy) after surgery and voice therapy., Conclusions: Our data indicated that both acoustic and perceptual characteristic of voice in patients with vocal polyps significantly improved after phonomicrosurgical and voice treatment., (Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: To investigate the potential risk factors associated to the treatment failure and recurrence of benign paroxysmal positional vertigo (BPPV)., Study Design: Prospective cohort study., Setting: Tertiary referral center., Patients: Four hundred patients with benign paroxysmal positional vertigo, 119 men and 281 women, aged 27 to 88 years., Intervention: Patients were treated once a week, with only one, appropriate, depending on the affected canal, repositioning maneuver (modified Epley, Semont, barbecue/inverted Gufoni, Kim). The control Dix-Hallpike test and the roll test were performed on 7 days., Main Outcome Measures: The treatment outcome and recurrence were evaluated with regard to sex, age, duration of symptoms, etiologic factors, migraines, osteoporosis, vascular risk factors, endocrine diseases, localization of otoconia, and simultaneous involvement of multiple canals., Results: The results indicate that treatment was negatively affected by patients' age, osteoporosis, and head trauma, without them causing recurrent symptoms. The highest number of uncured patients was observed in the 73- to 88-year-old age group (14.8%). The application of more than one maneuver was necessary in 27.5% of cases with primary BPPV and 88.9% with secondary BPPV. The highest treatment success was achieved in the group with BPPV of the posterior semicircular canal (F = 3.668, p = 0.026). The recurrence rate was 15.5%., Conclusion: Potential risk factors associated to the treatment failure were as follows: the age older than 50, secondary BPPV, head trauma, the occurrence of osteoporosis, and localization of otoconia in the anterior semicircular canal. The analyzed factors did not have impact on the recurrence.

Phonation is a fundamental feature of human communication. Control of phonation in the context of speech-language disturbances has traditionally been considered a characteristic of lesions to subcortical structures and pathways. Evidence suggests however, that cortical lesions may also implicate phonation. We carried out acoustic and perceptual analyses of the phonation of /a/ in 60 males with aphasia (20 Wernicke's, 20 Broca's, 20 subcortical aphasia) and 20 males matched in age with no neurological or speech-language disturbances. All groups with aphasia were significantly more impaired on the majority of acoustic and perceptual measures as compared with the control speakers. Within the subjects with aphasia, subjects with subcortical aphasia were more impaired on most measures compared to subjects with Broca's aphasia, and they, in turn, more impaired than those with Wernicke's aphasia. Lesions in regions involved in sound production-perception result in dysfunction of the entire neurocognitive system of articulation-phonological language processing., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objectives: The aim of the investigation was to obtain acoustic correlates of the vocal quality of patients with vocal polyps, before and after the endolaryngeal phonomicrosurgery (EPM)., Methods: Acoustic voice tests were carried out on 46 female patients with vocal fold polyp, before the EPM intervention and 3 weeks after its completion. Acoustic voice parameters were compared with the control group without voice pathology. The results of the investigation were analyzed acoustically., Results: The results showed that jitter (%), shimmer (%), fundamental frequency variation (vF(0)), voice turbulence index (VTI), pitch perturbation quotient (PPQ), amplitude perturbation quotient (APQ), and NHR values significantly differentiate the patients with vocal fold polyps from a control group without any pathological changes in the larynx. All of the analyzed parameters improved significantly (P<0.05) after the phonomicrosurgical intervention and tended to reach normal values., Conclusions: The acoustic voice analysis may be used for presurgical and postsurgical voice-status evaluation., (Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.)

Chronic inflammation of the middle ear is the most frequent cause of otogenic complications. Meningitis is the most frequent otogenic intracranial complication, followed by otogenic brain abscesses, while other complications are significantly less frequent. The study is aimed at presenting clinical causitry of otogenic brain abscesses consequential to chronic suppurative otitis in order to evaluate modern diagnostic and therapeutic possibilities. The study was retrospective and included the patients treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery of the Clinical Centre of Serbia diagnosed with otogenic brain abscess during a five-year period (1996-2000). A total of 9 patients (male to female ratio 8:1), aged 16-68 years, were assessed. The following parameters were analyzed: sex, age groups, place of living, occupation, number of hospitalizations, diagnostic procedures, symptoms and clinical signs of otogenic complications, other otogenic complications associated with brain abscess, endocranial localization of otogenic abscess, therapeutic procedures (oto-surgical treatment) and intraoperative otological findings. In our group of patients, otogenic brain abscesses were significantly more frequent in male patients in their forties, with median age of 33.5 years. As for the place of living, the patients from the provinces were more frequent, while with respect to their level of education, those with elementary or high school degrees were predominant. The inflammatory process most frequently spread into the endocranium through direct destruction of the bone walls of the middle ear. Diagnostic procedures included history, clinical otorhinolaryngological examination, audiological and vestibulological assessment, neurological ophthalmologic and radiographic examinations (CT, MRI). CT is the most reliable diagnostic tool enabling localization of the change, timing of surgical treatment and monitoring of surgical success. Presence of other otogenic complications associated with brain abscess was evidenced in six of our patients. Cerebral localization of abscess was more frequent (7). Four patients underwent previous oto-surgical treatment. The treatment included primary neurosurgical approach (radical extirpation or abscess drainage), followed by radical oto-surgical treatment after improvement of the patient's general condition.

The nasoparanasal region rhabdomyosarcoma belongs to the group of the rare malignant diseases, however it nevertheless represents major diagnostic and therapeutic problem. The study is aimed at presenting clinical casuistry of the nasoparanasal region rhabdomyosarcoma in adults and children, for the purpose of assessment of modern diagnostic and therapeutic possibilities. The study was retrospective and included the patients with evidenced and pathohistologically verified rhabdomyosarcoma of the nasoparanasal region diagnosed and treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery of the Clinical Centre of Serbia, during the period 1988-2001, and subsequently at the Institute of Oncology in Belgrade. The total of 9 patients aged 3-50 years (median 15) were assessed, with the female to male ratio being 4:5. Seven patients were previously hospitalized in other health institutions. The following parameters were analyzed: sex, age group, number of hospitalizations, diagnostic procedures, histological tumour types, mode of treatment and disease outcome. In 7 patients, the tumour spread beyond the nasoparanasal region--in 6 into the orbit, in 5 into the epipharynx, in 3 intracranially, in 1 into the pterygopalatine pit and in another 1 into the parapharyngeal space. Regional lymph nodes were affected only in one patient, while distant bone metastases were evidenced on another one. Embryonal type of the rhabdomyosarcoma was verified in 7 patients, while two had the alveolar type. In the affected children mean survival was significantly longer (76.3 months) in comparison to the one observed in adults (11.5 months). Therapeutic procedure included combined application of the chemotherapeutic protocols (adjusted with respect to the age group and stage of the disease) and radiotherapy. Radical surgical procedures were applied on in case of stage I tumours, and they may also be used in rest-relapse cases subsequent to the applied chemo-, i.e., radiotherapy.