Vomer aplasia in a patient carrying a de novo mutation of the TP63 gene (3q27)

The congenital vomer defect (CVD) is a rare and still partially unknown condition. Only few cases have been reported in the international literature and the large majority of them appeared to be isolated. We report a case of CVD detected in a 7-year-old girl affected by ectodermal dysplasia clefting syndrome caused by a mutation of the TP63 gene.

Reliability and validity of the Italian nose obstruction symptom evaluation (I-NOSE) scale

The NOSE scale is a questionnaire assessing QOL related with nasal obstruction. The aim of this study was to culturally adapt the NOSE scale into Italian (I-NOSE). Prospective instrument validation study. Cross-cultural adaptation and validation were accomplished. Cronbach α was used to test internal consistency in 116 patients complaining nasal obstruction and 232 asymptomatic subjects. Pearson and ICC tests were used for test-retest reliability analysis. Normative data were gathered from the 232 asymptomatic subjects. Mann-Whitney test was used to compare the I-NOSE scores in patients and asymptomatic subjects and in 40 patients before and after septoplasty. I-NOSE scores obtained in 60 patients were correlated with rhinomanometric results and with the score of a visual analog scale (VAS) measuring the subjective sensation of nasal obstruction. Good internal consistency and good test-retest reliability were found. I-NOSE mean score of the normal cohort was 12.1 ± 13.2. Asymptomatic subjects scored lower than patients with nasal obstruction (p = 0.001). Positive correlations between I-NOSE scores and VAS and rhinomanometric results were found. The mean I-NOSE score improved from 64.4 ± 23.6 to 22.1 ± 13.5 after septoplasty (p < 0.001). The I-NOSE scale is a reliable, valid, self-administered, symptom-specific questionnaire; its application is recommended.

Correlation between the Voice Handicap Index and voice measurements in four groups of patients with dysphonia

OBJECTIVES

To evaluate the correlation between the Voice Handicap Index (VHI) and objective voice measurements in patients with dysphonia of different origin.

STUDY DESIGN

Cross-sectional survey.

SETTING

Otolaryngology department in a university hospital.

SUBJECTS AND METHODS

One hundred fifteen patients consulting for voice disorders were enrolled in the study: 32 presented with functional dysphonia (Group 1), 24 with unilateral vocal fold paralysis (Group 2), 30 with structural dysphonia (Group 3), and 29 with nodules (Group 4). From each patient, the maximum phonation time (MPT) and a voice spectrogram were obtained: patients with type 1 signal underwent perturbation analysis. Each patient completed the VHI.

RESULTS

No significant difference across the four groups, in the VHI scores and voice measurements, was found. The correlation between the different voice measurements was good, while those between the VHI domains were very good. Considering the patients with type 1 signal (n = 80) all together, the correlations between VHI and voice laboratory measurements ranged between poor and good. Analyzing each patient group separately, good correlations were found between MPT and functional and physical VHI domain in Group 1 (r = 0.58 and 0.68), jitter and functional VHI domain in Group 2 (r = 0.61), MPT and functional VHI domain in Group 3 (r = 0.52), and physical VHI domain and jitter, shimmer, and noise-to-harmonic ratio in Group 4 (r = 0.58, 0.77, 0.76).

CONCLUSION

The VHI and the voice laboratory measurements give independent information. However, the correlation between VHI and some laboratory measurements increases in populations with voice disorder of the same origin.

Reliability and clinical validity of the Italian Reflux Symptom Index

Currently, there is no Italian version of the Reflux Symptom Index (RSI). The aim of this study was to develop an Italian RSI and to evaluate its internal consistency, reliability, and clinical validity. The study design used was a cross-sectional survey study. Eighty patients with a Reflux Finding Score (RFS) >7, and 193 asymptomatic subjects were included in the study. For the RSI reliability analysis, the appositely developed Italian RSI was filled twice, with a week interval, by the 80 patients and 80 control subjects. The test-retest reliability was assessed through the Pearson correlation test, whereas the Cronbach's alpha coefficient was used for internal consistency analysis. For the clinical validity assessment, the scores obtained in the pathological group were compared with the data from the asymptomatic individuals through the Student's t test. Finally, the correlation between RSI and RFS in the 80 patients was assessed. All of the patients filled in the entire questionnaire autonomously. The test-retest reliability in the patients, as well as in the control group, was very high (r>0.90); the internal consistency also showed very high values (alpha=0.99). The mean RSI score in the patients was 21.1+/-6.6, whereas in the control group it was 6.3+/-5.6; the difference was statistically significant (P=0.0001). The mean RFS score in the 80 patients was 9.2+/-2.7 and the correlation between RFS score and RSI score was rather high (r=0.89). The Italian RSI is easily administered, highly reproducible, and exhibits excellent clinical validity.