Total laryngectomy can be performed for the treatment of laryngeal diseases including laryngeal cancer, chronic aspiration, and bilateral vocal cord paralysis, glottic and subglottic stenosis. In case of chronic aspiration, glottic and subglottic stenosis total laryngectomy can be the last chance in extremely rare situations. Because of the high morbidity associated with this procedure, the development of a new treatment approach is paramount. Transoral robotic surgery is the newest treatment alternative. Here, we review published work on this approach.

Objective: The aim of this study was to assess the association between Apnea- Hypopnea ?ndex (AHI) and Red Cell Distribution Witdh (RDW) in patients with Obstructive Sleep Apnea Syndrome (OSAS) and to investigate whether RDW can be a predictor of disease severity before polysomnography.

Methods: This study was designed as retrospective and cross-sectional. Between January 2018 and March 2018, 109 consecutive patients with symptoms of snoring and sleep apnea included in this study.The study population was divided in to four groups:(i) Mild OSAS described as; AHI 5-14.9, (ii) moderate OSAS described as; 15-29.9, (iii) severe OSAS described as; AHI> 30 and (iv) control group decribed as AHI between 0-4.9 according to polyspmnography (PSG). Those with systemic disease that would affect RDW were excluded. Laboratory results and demographig data were extracted retrospectively.

Results: Of the patients included in the study, 83 (76%) were male and 26 (24%) were female. The mean age was 45.3 (43.7 for males and 50.8 for females), the mean Body Mass Index (BMI) was 30.3 (min: 19 - max: 51), the mean AHI was 22.6 (min: 0, max: 103) and the mean RDW was 13.5 (min: 12, max: 15.9). In our study, the RDW value was significantly higher in patients with OSAS compared to the control group. In the subgroup analysis, the highest RDW values were found in the severe OUAS group. Unlike the results from other studies,thelowest RDW value was found in the moderate OSAS group. However, no statistically significant difference was found between the groups. The severity of the disease was not correlated. This may be because the patient population is relatively small or there may be a distribution inequality between groups.

Conclus?ons: There is a relationshipbetween OSAS and RDW but more comprehensive, prospective and multi-centered studies must be performed.

While subglottal pressure, which is an aerodynamic parameter of sound, is a driving force for phonation, it is the primary factor in increasing sound intensity. The purpose of this study is to investigate the relationship between the aerodynamic parameters of sound and sound intensity between individuals who are singers and those who are not. The study included 20 volunteer male and female opera singing students who had received vocal training and did not have any voice-related pathologies and 20 male and female medical students who had not received any vocal training. As aerodynamic components, the subglottal air pressure, subglottal airflow and sound pressure level data of the participants were collected by using an Aero view Pro Phonatory Aerodynamics System kit. Estimated subglottal aerodynamic measurements were taken by using a Rothenberg mask. The sound pressure levels were additionally measured by a Sound Level Meter (2240 B&K), and the results of the two methods were compared. For the measurements, the individuals were asked to vocalize the plosive consonant of “pa” in an anechoic room. Subglottal airflow was higher in the students who had not received vocal training (1.96±0.54) in comparison to the opera singing students (1.48±0.31) (p<0, 05). Subglottal air pressure was higher in the students who had vocal training (14.36±2.99) in comparison to those who did not have vocal training (11.32±3.47) (p<0, 05). The sound intensity levels of those who had vocal training (108.53 ± 3.48) were higher than those who did not have vocal training (101.43±4.52) (p< 0, 05).The mean sound intensity check measurement value was also higher in the group with vocal training (p<0, 05).It was confirmed by data than an increase in subglottal pressure is a predictor of an increase in sound intensity. Subglottal airflow had a constant continuity, and it did not seem to be effective in changing sound intensity. In addition, the mean correlation between subglottic pressure and SPL was found to be the 0.85 coefficient. Singing teaches how to use the laryngeal structures effectively in an aerodynamics sense.