It is difficult to quantify the incidence of hyperfunctional muscle tension dysphonia (H-MTD). Although voice disorders in general have been noted to affect approximately 10% of the population in the United States, up to 40% of patient visits to voice specialists are for symptoms of H-MTD. Clearly this condition is a very common vocal pathology, yet its differential diagnosis is not always straightforward. The primary purpose of this tutorial is to present a comprehensive literature review on this condition, with particular focus on alternative etiologic theories and differential diagnostic and treatment techniques. The secondary purpose of this tutorial is to increase awareness that this disorder is a complex condition with highly variable causes, features, and treatment requirements. As a consequence of recent advances in the field of neurolaryngology, and for completeness, the neurological substrates of voice and speech production are also discussed in this review. This information is included to evoke a theoretical onversation about possible patho-neurologic correlates in some patients with H-MTD; especially those who do not respond favorably to standard behavioral therapy strategies. Whereas only a brief discussion of treatment options is rendered in this paper, more detailed information on this topic will be covered in a forthcoming companion tutorial.

Objectives: The aim of this study was to examine the accuracy of fine needle aspiration with cytology (FNAC) for thyroid gland masses without (US) ultrasound guidance by comparing results with final Histopathological Examination (HPE) findings. Study Design: Retrospective chart review Setting: Tertiary Care Medical Center in Montego Bay, Jamaica. Subjects and Methods: Patient charts were retrospectively reviewed at Cornwall Regional Hospital in Montego Bay, Jamaica. Individuals with thyroid nodules less than 3 cm were excluded. Non-ultrasound guided FNA was performed by the attending otolaryngologist and cytology was analyzed by the attending pathologist. FNAC results were compared to final HPE results. A total of 412 patients were sampled.

Background: Primary external auditory canal (EAC) malignancies are very rare with adenoid cystic carcinoma (ACC) representing approximately 5% of these tumors. There is insufficient knowledge of the natural behavior of ACC in EAC. The disease needs early detection and complete treatment because of its tendency to recur, vicinity to sensitive organs and lower response to radiation.

Objectives: To find out and evaluate and compare hearing threshold of the cleft-side vs. non-cleft side in children with unilateral cleft lip and palate (UCLP), to find out if the severity of the morphological and functional changes on the cleft lip and palate side correlate with severity of the hearing loss, to find out if ears of cleft vs.non cleft side show difference in improvement of the hearing loss with aging.

We have long known that emotions can affect health. Depression, anxiety, stress, all these have an effect on health. Psychoneuroimmunology - PS - studies the precise chemical and neural connections that are effected [1]. PS developed when Norman Cousins, the editor of the popular Saturday Evening Post, was dying at the UCLA hospital. The doctors had given up. His friends hung a sheet, had him watch comedies, he laughed, and he got well. He then wrote, Anatomy of An Illness, and founded the fi eld of Psychoneurimmunology: how emotions affect the body [2].

Background: Abnormalities of smooth pursuit eye movement (SPEM) are a clinical fi nding in central equilibrium disorders; the evaluation of SPEM using video-oculography (VOG) has therefore been conducted clinically in recent years. However, evaluation criteria for determining a saccadic pattern have yet to be clearly defined.