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A simple technique for sizing an endoscopic image
Otolaryngology Head and Neck Surgery P 172
Scientific Posters
with those of gastroenterology patients with documented esophagitis. Results: The mean EAC for the LPR group was 1.14 + 0A9 minutes. This value for EAC is "faster" than normal and significantly different from that of gastroenterology patients with erosive esophagitis (t9 < 0.01). Conclusions: It has been postulated that otolaryngology patients with LPR often deny having heartburn and have a relatively low incidence of esophagitis because they are daytime, upright refluxers with relatively normal esophageal motility. The data of this study support this hypothesis and reinforce the belief that otolaryngology patients with LPR may experience reflux by different mechanisms than those reported for gastroenterology patients.
August 1997
loss. It is often difficult to differentiate basilar migraine (migraine-related) vertigo from other neurotologic disorders. Sumatriptan succinate (Imitrex| is a selective serotonin (5-HT) agonist that is extremely effective in relieving the pain from migraine headaches. The major binding site for sumatriptan is the 5-HTld receptor, which has also been identified in the medial vestibular nucleus. To our knowledge there are no reports on the potential use of sumatriptan in the treatment of migraine-related vertigo. We present our preliminary findings in six patients who were treated with sumatriptan; two of these patients had vertigo in the office with documented neurotologic findings that immediately resolved after sumatriptan injection. 36
34 A Simple Technique for Sizing an Endoscopic Image
Incidence of Abnormal Laryngeal Findings in Singing Students
N. WENDELLTODD, MD, and STEVEN J. MCMAHON, MD, Atlanta, Ga.
DONNA S. LUNDY, MA, ROY R. CASIANO, MD, SOHAM ROY, MD, PAULA A. SULLIVAN, MS, and JUN WU XUE, MD, Miami, Fla.
Background: Accurate assessment of the size of an item viewed endoscopically is problematic. Even with the use of a calibrated reference placed in the field, intra-observer errors of 73% of lesion diameter are reported. Objective: To evaluate a technique requiring neither saved image nor computer analysis and that is not compromised by peripheral image distortion. Technique: The technique relies on the linear relationship of image diameter versus distance of tip of the scope from the region of interest. The endoscopist determines the distance that the scope has moved from touching the region of interest, until that region of interest fills the diameter of the endoscopic view. Methods: Repeated in vitro assessments of a rectilinear graph imaged through three flexible fiberoptic endoscopes. Results: The diameter of the imaged region is directly related to the distance of the tip of the endoscope from the imaged region for each of the three flexible fiberoptic scopes studied. The repeatability of imaged diameter is good, as evidenced by small ranges and small standard deviations. Conclusions: The technique, accurate within 30% for a 10 mm diameter region of interest, is applicable to fiat regions of interest perpendicular to the axis of the tip of a flexible fiberoptic endoscope. Minor scope improvements would enhance accuracy.
Objective: Abnormalities in the mucosal lining of the vocal folds may interfere with the normal vibratory patterns and result in vocal limitations, especially for singers whose demands are great. A prospective, longitudinal study was undertaken to investigate the incidence of laryngeal abnormalities in asymptomatic singing students. Methods: Sixty singing students at the School of Music underwent videostroboscopic evaluation and completed a comprehensive questionnaire. Videos were rated by three experienced clinicians, and interrater reliability was calculated. Results were correlated with demographic factors, background medical history, and singing history. Results: Five students (8.3%) exhibited early signs of benign vocal fold lesions (two with nodules and three with cysts). A high incidence of posterior erythema (n = 44; 73.4%) suggesting possible reflux was found. Forty-eight students (80%) demonstrated incomplete glottic closure. Conclusions: A surprisingly high number of otherwise asymptomatic singing students demonstrated abnormal laryngeal findings. Their relationship with vocal performance will be addressed as well as implications for preventative measures.
35
Aspiration: Etiology and Implications
Treatment of Migraine-related Vertigo With Sumatriptan Succinate STEVEN V. RICHARDS, MD, JAMES E. SAUNDERS, MD, GLENN THOMPSON, PhD, and B. HILL BRITTON, MD, Edmond and Oklahoma City, Okla.
Migraine headache affects nearly 20% of the population, and many of these patients will experience some form of dizziness. Basilar migraine is a distinct variant of migraine headache with predominantly neurotologicat symptoms including vertigo, disequilibrium, aural pressure, tinnitus, phonophobia, or hearing
37
D O N N A S. LUNDY, MA, PAULA A. SULLIVAN, MS, JERI A. L O G E M A N N , PhD, CATHY LAZARUS, MS, LISA N E W M A N , ScD, JOY GAZIANO, MS, T H O M A S MURRY, PhD, and LORI LOMBARD, MS, Miami and Tampa, FLa.,Evanston and Chicago, II1.,Memphis, Tenn., and Pittsburgh, Pa.
Objective: Aspiration is a serious symptom of dysphagia with potentially dire consequences. Appropriate treatment, surgical and/or medical, is dependent on differentiating the etiology between anatomic or physiologic difficulties that occur before, during, or after the swallow. A prospective multi-institutional study was undertaken to assess the over-
Scientific Posters
with those of gastroenterology patients with documented esophagitis. Results: The mean EAC for the LPR group was 1.14 + 0A9 minutes. This value for EAC is "faster" than normal and significantly different from that of gastroenterology patients with erosive esophagitis (t9 < 0.01). Conclusions: It has been postulated that otolaryngology patients with LPR often deny having heartburn and have a relatively low incidence of esophagitis because they are daytime, upright refluxers with relatively normal esophageal motility. The data of this study support this hypothesis and reinforce the belief that otolaryngology patients with LPR may experience reflux by different mechanisms than those reported for gastroenterology patients.
August 1997
loss. It is often difficult to differentiate basilar migraine (migraine-related) vertigo from other neurotologic disorders. Sumatriptan succinate (Imitrex| is a selective serotonin (5-HT) agonist that is extremely effective in relieving the pain from migraine headaches. The major binding site for sumatriptan is the 5-HTld receptor, which has also been identified in the medial vestibular nucleus. To our knowledge there are no reports on the potential use of sumatriptan in the treatment of migraine-related vertigo. We present our preliminary findings in six patients who were treated with sumatriptan; two of these patients had vertigo in the office with documented neurotologic findings that immediately resolved after sumatriptan injection. 36
34 A Simple Technique for Sizing an Endoscopic Image
Incidence of Abnormal Laryngeal Findings in Singing Students
N. WENDELLTODD, MD, and STEVEN J. MCMAHON, MD, Atlanta, Ga.
DONNA S. LUNDY, MA, ROY R. CASIANO, MD, SOHAM ROY, MD, PAULA A. SULLIVAN, MS, and JUN WU XUE, MD, Miami, Fla.
Background: Accurate assessment of the size of an item viewed endoscopically is problematic. Even with the use of a calibrated reference placed in the field, intra-observer errors of 73% of lesion diameter are reported. Objective: To evaluate a technique requiring neither saved image nor computer analysis and that is not compromised by peripheral image distortion. Technique: The technique relies on the linear relationship of image diameter versus distance of tip of the scope from the region of interest. The endoscopist determines the distance that the scope has moved from touching the region of interest, until that region of interest fills the diameter of the endoscopic view. Methods: Repeated in vitro assessments of a rectilinear graph imaged through three flexible fiberoptic endoscopes. Results: The diameter of the imaged region is directly related to the distance of the tip of the endoscope from the imaged region for each of the three flexible fiberoptic scopes studied. The repeatability of imaged diameter is good, as evidenced by small ranges and small standard deviations. Conclusions: The technique, accurate within 30% for a 10 mm diameter region of interest, is applicable to fiat regions of interest perpendicular to the axis of the tip of a flexible fiberoptic endoscope. Minor scope improvements would enhance accuracy.
Objective: Abnormalities in the mucosal lining of the vocal folds may interfere with the normal vibratory patterns and result in vocal limitations, especially for singers whose demands are great. A prospective, longitudinal study was undertaken to investigate the incidence of laryngeal abnormalities in asymptomatic singing students. Methods: Sixty singing students at the School of Music underwent videostroboscopic evaluation and completed a comprehensive questionnaire. Videos were rated by three experienced clinicians, and interrater reliability was calculated. Results were correlated with demographic factors, background medical history, and singing history. Results: Five students (8.3%) exhibited early signs of benign vocal fold lesions (two with nodules and three with cysts). A high incidence of posterior erythema (n = 44; 73.4%) suggesting possible reflux was found. Forty-eight students (80%) demonstrated incomplete glottic closure. Conclusions: A surprisingly high number of otherwise asymptomatic singing students demonstrated abnormal laryngeal findings. Their relationship with vocal performance will be addressed as well as implications for preventative measures.
35
Aspiration: Etiology and Implications
Treatment of Migraine-related Vertigo With Sumatriptan Succinate STEVEN V. RICHARDS, MD, JAMES E. SAUNDERS, MD, GLENN THOMPSON, PhD, and B. HILL BRITTON, MD, Edmond and Oklahoma City, Okla.
Migraine headache affects nearly 20% of the population, and many of these patients will experience some form of dizziness. Basilar migraine is a distinct variant of migraine headache with predominantly neurotologicat symptoms including vertigo, disequilibrium, aural pressure, tinnitus, phonophobia, or hearing
37
D O N N A S. LUNDY, MA, PAULA A. SULLIVAN, MS, JERI A. L O G E M A N N , PhD, CATHY LAZARUS, MS, LISA N E W M A N , ScD, JOY GAZIANO, MS, T H O M A S MURRY, PhD, and LORI LOMBARD, MS, Miami and Tampa, FLa.,Evanston and Chicago, II1.,Memphis, Tenn., and Pittsburgh, Pa.
Objective: Aspiration is a serious symptom of dysphagia with potentially dire consequences. Appropriate treatment, surgical and/or medical, is dependent on differentiating the etiology between anatomic or physiologic difficulties that occur before, during, or after the swallow. A prospective multi-institutional study was undertaken to assess the over-