Biomedical subjects
R T Sataloff
Publications and source records attributed to R T Sataloff.
Professional singers: the science and art of clinical care.
Voice complaints of serious singers are usually not imaginary, and rational diagnosis and treatment can be achieved through systematic inquiry and analysis based on anatomy, physiology, psychology and psychoacoustics of voice production. Good vocal habits should be encouraged from childhood. Measures to aid in voice conservation include avoiding singing in noisy, dry, dusty, and smoky environments and learning to control the voice in circumstances in which auditory monitoring of the intensity of vocalization cannot be done effectively. The dangers of cheerleading, choir-conducting, and other forms of abuse of the speaking voice for the serious singer are emphasized. Young singers should be enthusiastically encouraged to sing music suitable for their ages and voices, and should be discouraged from taking on difficult roles prematurely. Smoking must be avoided. Thorough training and regular practice are essential for maintenance of a healthy singing voice. Close cooperation among laryngologist, speech pathologist and voice teacher is emphasized. Treatments for reflux laryngitis, anxiety, muscle spasm, voice abuse, vocal nodules, and infectious laryngitis in the professional singer are detailed.
Choosing the right hearing aid.
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Otitis media: a common childhood infection.
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Special anesthetic techniques in head and neck surgery.
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Special equipment in the operating room for otolaryngology-head and neck surgery.
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CME program. Tracheotomy and inhalation injury.
Indications for tracheotomy in patients with respiratory burns have been unclear. Much of the literature is inconclusive or misleading. A thorough understanding of the pathogenesis, diagnosis, and therapy of inhalation injury is necessary to understand the role of tracheotomy. A critical review reveals relatively clearcut indications for the use of tracheotomy in inhalation injury, but many unanswered questions. Increased participation by otolaryngologists in burn management is recommended.
Computed tomography of the face and paranasal sinuses: Part II. Abnormal anatomy and pathologic conditions.
Computerized tomography is extremely useful in delineating abnormal anatomy and pathologic conditions of the face and paranasal sinuses. The familiarity with normal anatomy is essential. Expert interpretation of CT scanning allows superior diagnosis of and treatment planning for lesions of the face and paranasal sinuses.
Histoplasmosis of the larynx.
INTRODUCTION: Laryngeal histoplasmosis was first described in 1952. Since then, fewer than 100 cases had been reported. This dimorphic fungus is endemic in the Mississippi and Ohio River Valleys. The yeast phase is responsible for human infection. METHODS: We report a 44-year-old woman who developed laryngitis. The markedly abnormal larynx, which could have been mistaken for papillomatosis, was biopsied, at which time the diagnosis of histoplasmosis was confirmed. Treatment with oral ketoconazole was instituted. RESULTS: Objective voice assessment showed abnormalities of maximum phonation time, speaking fundamental frequency, perturbation, percent voicing, mean flow rate, and spectral pattern. Subsequent to antifungal therapy, objective measures were improved. CONCLUSION: This represents the first case of laryngeal histoplasmosis in which response to therapy is documented by objective vocal assessment.
Vestibular nerve section.
INTRODUCTION: Vestibular nerve section is considered to be the most effective surgical procedure for control of intractable symptoms secondary to labyrinthine and eighth nerve function. This study was developed to retrospectively evaluate the efficacy of vestibular nerve section in patients treated for disabling labyrinthine dysfunction. METHODS: A retrospective review of hospital and office records was carried out on 39 patients who underwent vestibular nerve section. All patients received a comprehensive questionnaire to subjectively evaluate efficacy. RESULTS: Questionnaires were returned from 36 of 39 patients. Follow-up averaged 51 months. A decrease in vertiginous attacks was reported by 94% of patients. An improvement in activity tolerance was reported by 30% of patients. Preoperative tinnitus and ear fullness reportedly improved after surgery in 53% and 65% or patients respectively. Complications encountered included cerebrospinal fluid (CSF) leak (six patients), meningitis (two patients), and intracranial fluid collection (one patient). CONCLUSION: Vestibular nerve section is a relatively safe and effective method of treatment for intractable vertigo.
Intracanalicular arachnoid cyst mimicking acoustic neuroma: CT and MRI.
A patient with a surgically proven intracanalicular arachnoid cyst was studied using computed tomography, magnetic resonance imaging, and air CT cisternography. The lesion had a similar radiographic appearance to acoustic neuroma and therefore, although rare, must be considered in the differential diagnosis of intracanalicular mass lesions. We report a case in which examination was performed, in evaluating the lesion, utilizing high-resolution air CT cisternography and magnetic resonance imaging (MRI).
Airway management in Hallermann-Streiff syndrome.
Hallermann-Streiff syndrome and other craniofacial anomalies predispose patients to airway emergencies. Anatomic abnormalities may render both intubation and tracheotomy unusually difficult. It is important for the otolaryngologist to be familiar with the special difficulties and hazards associated with these malformations in order to ensure optimal airway management.
Intermittent exposure to noise: effects on hearing.
Most studies of the effects of noise upon hearing have dealt with continuous noise exposure. Previous reports on intermittent exposure to noise concluded that it causes less damage to hearing than does continuous exposure to noise of the same intensity. In this investigation, 12,000 workers were screened to find 295 subjects who met the strict criteria of the study. Most of the subjects were exposed to jackhammer noise at peak levels of 118 dBA. Intermittent exposure to intense noise results in very severe loss in high frequencies but relatively little or no hearing loss in the lower frequencies even after many years of exposure. This differs substantially from the effects of continuous exposure to noise of the same intensity. It remains to be determined whether this pattern of hearing results from intermittent exposure to all sorts of noise or only from the kinds of sources investigated in this study.
Airway reactivity induced reversible voice dysfunction in singers.
As the power source for vocalization, the lower respiratory tract plays a key role in voice production. This is particularly true with sustained singing, where continued high ventilatory demands are present. Changes in pulmonary function that are insignificant with normal speech have been shown to lead to performance impairment. The purpose of this study was to examine and characterize this problem in a large group of singers. Systematic evaluation of a defined population, along with inhalational and singing challenge, was the design. The demographic characteristics, history, pulmonary function, and response to treatment were evaluated in 20 professional or serious amateur singers with voice problems, who did not have causal laryngeal pathology, whose history and evaluation suggested increased airway reactivity, and who responded to anti-asthma therapy. An additional patient was challenged by the exercise of singing in the office, with pulmonary function measurements before and after. This group of serious singers demonstrated vocalization complaints referable to bronchodilator responsive airway obstruction. They responded to treatment for asthma, with improvement in their performance-related difficulties. An additional subject demonstrated a small decline in expiratory flow rates with only 20 minutes of singing in the office. This was readily reversed by an inhaled bronchodilator. Singers who present with complaints of impaired vocalization, such as vocal fatigue, decreased control, and excessive muscular tension, should be evaluated for increased airway reactivity as a possible cause of their complaints.
Professional voice users: the evaluation of voice disorders.
Substantial advances in understanding the anatomy and physiology of phonation, and the new technology that has improved voice measurement and voice surgery, have led to marked improvement in the standard-of-care for patients with voice disorders. Expert voice care is essential for all patients, but especially crucial for voice professionals. Professional voice users include not only singers and actors, but also clergy, teachers, receptionists, sales personnel, physicians, and anyone else whose ability to earn a living is impacted negatively by loss of vocal quality and endurance. Physicians should be familiar with the latest concepts in voice diagnosis and treatment, and with the management of common voice disorders.
Audiologic testing: an overview for occupational physicians.
This chapter summarizes the audiologic tests likely to be encountered by occupational physicians caring for workers with hearing loss complaints. These include audiometric tests, electrocochleography, evoked-response audiometry, and tests designed to examine for central nervous system damage.