Search PubMed⌕ Search

Biomedical subjects

Robert T Sataloff

Publications and source records attributed to Robert T Sataloff.

At least 19 recordsLinked to original sources

Laryngeal hyperfunction during whispering: reality or myth?

For years, otolaryngologists and voice therapists have warned voice patients that whispering causes more trauma to the larynx than normal speech. However, no large series of patients has ever been examined fiberoptically during whispering to test this hypothesis. As part of our routine examination, patients are asked to count from 1 to 10 in a normal voice and in a whispered voice. We reviewed recorded fiberoptic examinations of 100 patients who had voice complaints. We compared supraglottic hyperfunction and vocal fold closure during the normal and whispered phonation of each patient. Sixty-nine percent of the patients demonstrated increased supraglottic hyperfunction with whispered voice. Eighteen percent had no change, and 13% had less severe hyperfunction. The most common glottal configuration during whisper was an inverted Y, which resulted from compression of the anterior and middle thirds of the true vocal folds. However, 12 patients had no true vocal fold contact during whispered voice, despite having adequate glottic closure with normal voice. Although whispering involves more severe hyperfunction in most patients, it does not seem to do so in all patients. In some patients, it may be less traumatic than normal voice.

Adult↗

The academic practice of otolaryngology: philosophical and practical perspectives.

The academic practice of otolaryngology does not end after residency, nor does it depend upon employment in an academic institution or affiliate. Academic practice is a state of mind and a mode of living. It is a commitment to intellectual vitality, and to recognizing, but never accepting, the limits of our knowledge. It is a call to keep asking questions and to pursue answers methodically, and it is a commitment for each of us to leave the field of otolaryngology better than we found it.

Academic Medical Centers↗

Noise-induced perilymph fistula.

Perilymph fistulae are difficult to diagnose because they present with a wide variety of signs and symptoms, they are associated with many etiologies, and they often mimic other conditions. In this article, we describe a case of perilymph fistula that featured one of its more rare causes: acoustic trauma--specifically, damage from a loud blast from the siren of a fire engine. We also review the literature and discuss the difficulties of diagnosis and treatment and the possible mechanisms by which acoustic trauma and other etiologies cause perilymph fistulae.

Adult↗

Vocal process avulsion.

Vocal process avulsion is a rare complication of intubation or external laryngeal trauma that can cause significant dysphonia. The vocal process develops independently from the body of the arytenoid cartilage, which results in a fusion plane that is vulnerable to trauma. The findings of vocal process avulsion may be subtle, and the relationship of the vocal process to the body of the arytenoid cartilage must be examined closely. Stroboscopy is critical in the evaluation. We describe three cases of vocal process avulsion encountered by the senior author (R.T.S.) over the last 5 years and discuss our approaches to evaluation and treatment. All cases were repaired endoscopically. However, we used three different techniques. These include chemical tenotomy with botulinum toxin, closed reduction with fat injection, and open reduction via cordotomy.

Adipose Tissue↗

Corticosteroid response and supporting cell antibody in autoimmune hearing loss.

OBJECTIVE: To determine whether antibodies to supporting cells are associated with response to corticosteroids in patients with autoimmune sensorineural hearing loss. DESIGN: Prospective analysis of antibody to inner-ear antigens. SETTING: Collaborating otology practices in Pennsylvania, Michigan, and Indiana. PATIENTS: Sixty-three patients with rapidly progressive unilateral or bilateral sensorineural hearing loss of unknown cause suggestive of autoimmune sensorineural hearing loss. INTERVENTIONS: Pretreatment audiometry, serum analysis by Western blot (WB) and immunofluorescence (IF) tests, corticosteroid therapy, and follow-up audiometry. MAIN OUTCOME MEASURES: Antibody reactivity and audiogram changes were analyzed for association with response to treatment. RESULTS: More than half of the patients (37/63) had antibodies to both a 68- to 72-kDa protein and to inner-ear supporting cells, 16 patients had positive results on one assay only, and 10 had negative results on both. Twenty-eight patients improved and 35 did not. The WB findings did not correlate with response. Of the WB-positive patients, 49% (21/43) improved, as did 35% (7/20) of the WB-negative patients (P = .30). In contrast, 53% (25/47) of IF-positive patients improved, compared with only 19% (3/16) in the IF-negative group (P = .02). Of those who improved, 89% (25/28) were IF positive. CONCLUSIONS: Antibody to an inner-ear supporting cell antigen was significantly associated with hearing improvement after corticosteroid therapy (relative rate, 2.8). Patients with IF-positive serum are nearly 3 times more likely to experience improved hearing with corticosteroid treatment than those who are IF negative. Antibodies to inner-ear supporting cell antigen may have value in diagnosis and treatment of patients with autoimmune sensorineural hearing loss.

Adult↗