Zakaitienė, Gabrielė

Introduction: Radiotherapy (RT) is a treatment modality for laryngeal cancer in its early stages and in several advanced stages neoplasms combined with chemotherapy (CRT). Aim of the study: To analyze the results of primary RT in the treatment of laryngeal cancer and patients survival rate. Materials and methods: 95 patients who underwent primary RT or CRT for biopsy-proven laryngeal squamous cell carcinoma or carcinoma in situ (CIS) during 2007-2017 were included in the study. Patients records, videolaryngostroboscopy (VLS) and Computer Tomography (CT) results, treatment modalities, outcomes and death data were investigated. 5-year survival rate was calculated and compared within the groups. Influence of different factors on recurrence and progression of the disease as well as on patients survival prognosis was analyzed. Results: 30% of patients were identified as having 1st stage cancer, 22% - 2nd stage , 14% - 3rd stage, 22% - 4th stage and 12% CIS. Most of the patients' histology revealed Grade 2. Nodal disease was presented in 26% of cases. 19% revealed to have recurrence of the disease, 11% progression, 2% both recurrence and necrosis, 4% necrosis alone and 20% subjects outcome is unknown due to not attending the follow up. Recurrence did not depend on stage, though progression of disease was higher in advanced-stage (3rd-4th stages) group (p=0.02). Neither recurrence nor progression depended on age, grade, VLS and CT parameters (p>0.5). Progression of disease was higher in patients who presented nodal disease (p=0.01). 5-year survival in 1st, 2nd, 3rd, and 4th stages were 69%, 40%, 47%, and 38% respectively. Statistically significant difference was found between early (47 months) and advanced (37.6 months) stages survival (p=0,01). Death risk rate was 3.4 times higher in advanced stage group patients who were treated with RT alone compared to those treated with CRT. For the recurrence or necrosis, salvag[...].

Introduction Radiotherapy is a treatment modality for laryngeal cancer in its early stages, also in combination with chemotherapy for several advanced stages neoplasms as organpreservation or palliative method. However, there remains a proportion of cases where residual or recurrent cancer appears, or where radiotherapy causes a larynx dysfunction and radionecrosis. In these circumstances salvage surgery is often necessitated. Knowing diseasespecific and disease-free survival rates, also the prevalence of possible complications and its risk factors are important predictors to prognose treatment of patients. Aim The goal of this study is to investigate the effectiveness of primary radiotherapy for laryngeal cancer treatment and to study possible risk factors for recurrent disease and radionecrosis. Methods A retrospective study was conducted in Lithuanian University of health sciences University hospital Kaunas Clinics. Patients with biopsy-proven primary squamous cell carcinoma of the larynx who underwent radiotherapy alone or together with chemotherapy in 2007-2017 were identified. Subjects who already were diagnosed with another localisation cancer or had primary treatment with surgery were excluded. Patient records were collected also videolaryngostroboscopies (VLS) and computer tomographies (CT) were analised. Information extracted from patient records included: patient demographics, concomitant diseases, pretreatment hemoglobin, oncological data, details of initial and salvage treatment, treatment and survival outcome. Invasion of anterior commissure in VLS and CT and laryngeal cartilages exposure in CT before primary treatment were studied. Detailed analysis of radiotherapy dosages, fractions, volume pertaining to cartilage was done by the professional oncologist. According to TNM staging subjects were divided into two groups: early stage group (I-II) and an advanced stage group (III-IV). Results Disease[...].

Introduction: Hearing Handicap Inventory for the Elderly is a 10-item self-administered questionnaire (0-40 points) created for the assessment of hearing related quality of life for the elderly. There was no specialised subjective method to measure handicap of elderly in Lithuania due to hearing problems so far. Aim: To determine the reliability and validity of the Lithuanian version of the Hearing Handicap Inventory for the Elderly (HHIE-LT). Methods: Linguistic and cultural adaptation was made according to guidelines including professional translators, retranslators, editors, ENT specialist committee and pilot study. After getting the final version of HHIE-LT, a total of 102 subjects older than 65 years were included in the study: 72 patients who had hearing complaints (patients group) and 30 healthy elderly people (control group). All subjects filled HHIE-LT as well as had an audiological evaluation. To assess construct validity, participants completed the Lithuanian version of 36-Item Short Form Health Survey (SF-36). Test-retest and internal consistency reliability as well as construct validity were calculated. Results: The Lithuanian version of the HHIE and its subscales showed a robust internal consistency reliability (Cronbach\’s α=0,95) as well as retest questionaire stability (Cronbach\’s α>0,89). There was no statistically significant difference within test-retest results over time (p=0.25). Statistically significant correlations were observed between the HHIELT and SF-36 social (r=0,54) and emotional (r=0,46) scales. There was a statistically significant difference (p<0.001) between the mean scores of the patients (29,36±8,7 points) and control groups (1,7±8,7points). ROC analysis showed that the cut point differentiating people with and without hearing loss is 8 points with sesitivity of 96% and Specificity of 99%. A statistically significant high correlation (r=0,8) was observed withi...

Darbo tikslas. Įvertinti Dainininkų balso neįgalumo indekso pranašumus, vertinant dainininkų balso problemas. Tyrimo medžiaga ir metodai. Į perspektyvųjį tyrimą įtraukta 110 suaugusių žmonių, iš kurių 60 dainininkų ir 50 sveikų ne dainininkų. Laringologinis ištyrimas buvo atliktas pagal ELD gaires, atliekant vaizdo laringostroboskopiją (VLS), balsą vertinant faktorine užkimimo skale (LGP), akustine analize (5 parametrai) bei fonetograma (7 parametrai), išmatuojant ilgiausią fonacijos trukmę. Subjektyviai balso analizei naudoti Gerklų funkcijos indeksas (GFI), Balso neįgalumo indeksas (BNI) ir Dainininkų balso neįgalumo indeksas (DBNI). Atlikus VLS ir daugiaparametrinį balso ištyrimą, dainininkai buvo padalyti į dvi grupes: sveikus ir užkimusius. Nustatyti ir tarpusavyje palyginti dainininkų ir ne dainininkų grupių indeksų patologinių reikšmių (GFI>3 balų, BNI>18 balų, DBNI>43 balų) dažnis (proc.) bei vidurkiai. Palyginti klausimynų diagnostiniai jautrumai ir specifiškumai, ryšys su akustiniais, aerodinaminiais parametrais. Rezultatai. Sveikų dainininkų ir ne dainininkų GFI ir BNI vidutinių reikšmių skirtumas buvo statistiškai reikšmingas (p<0,05). Dainininkų grupėje rastas statistiškai reikšmingas skirtumas (p<0,05) tarp įtariamos disfonijos nustatymo dažnio universaliais klausimynais ir DBNI. Apskaičiuotas klausimynų diagnostinis jautrumas ir specifiškumas: GFI 72 proc. ir 77 proc., BNI 77 proc. ir 86 proc., DBNI 88 proc. ir 74 proc. Rastos silpnos/vidutinės BNI ir DBNI koreliacijos su 4 akustinės analizės ir fonetogramos parametrais (r=0,26-0,39, p<0,05), tačiau tik DBNI statistiškai reikšmingai koreliavo su tonų diapazonu, fonetogramos plotu ir ilgiausios fonacijos trukme (r= -0,28-0,39, p<0,05). Išvada. DBNI turėtų būti pirmos eilės metodas, atliekant subjektyvų dainininkų balso tyrimą bei dainininkų pirminę balso sutrikimų atranką.

Įžanga Daininininkų darbingumo užtikrinimui itin svarbi ankstyva balso sutrikimų diagnostika ir savalaikis gydymas [1]. Diagnostikai naudojami specializuoti balso sutrikimų poveikį kasdieninei ir profesinei veiklai išreiškiantys klausimynai, pvz.: Dainininkų balso neįgalumo indeksas (DBNI) [2,3]. Atlikus kalbinę-kultūrinę adaptaciją, 2014m. LSMU ANG klinikoje įdiegtas lietuviškas DBNI. Tikslas Įvertinti lietuviško DBNI diagnostinę reikšmę. Uždaviniai 1. Nustatyti ir palyginti naujai įdiegto DBNI vidurkius tarp sveikų ir užkimusių dainininkų. 2. Ištirti DBNI ryšį su kitais balso tyrimo parametrais. 3. Įvertinti DBNI diagnostinį jautrumą ir specifiškumą. 4. Apibendrinti DBNI diagnostinę reikšmę. Metodika Prospektyviniame tyrime dalyvavo 60 dainininkų. Dainininkais laikyti asmenys balsą nepertraukiamai lavinantys ne mažiau 2 metus, reguliariai dainuojantys ir koncertuojantys ne mažiau 2 valandas per savaitę [4]. Laringologinis ištyrimas buvo atliktas pagal Europos laringologų draugijos gaires [3], atliekant vaizdo laringostroboskopiją (VLS), balsą vertinant faktorine užkimimo skale (LGP), akustine analize (5 parametrai) bei fonetograma (7 parametrai), išmatuojant ilgiausią fonacijos trukmę (IFT). Subjektyviam balso vertinimui naudotas 4 klausimų Gerklų funkcijos indeksas (GFI) ir naujai įdiegtas 36 klausimų lietuviškas DBNI (0-144 balai). Pagal tyrimų rezultatus tiriamieji suskirstyti į 2 grupes: sveikus ir užkimusius. Išanalizuotos užkimimą sukėlusios priežastys. DBNI ir kitų balso tyrimų rezultatai palyginti tarp grupių (Student t). Įvertintas DBNI ryšys su kitais balso tyrimais (Pearson koreliacijos koeficientas r). DBNI ribinė reikšmė, atskirianti sveiką balsą nuo užkimusio nustatyta atliekant ROC analizę. Apskaičiuotas DBNI diagnostinis jautrumas ir specifiškumas (proc.). Tikrinant statistines hipotezes, pasirinktas 0,05 reikšmin[...].

Introduction. Spetzler-Martin grading system (SMGS) has been widely accepted to estimate treatment risks and predict the outcome of patients with intracranial AVM and currently, the majority of neurosuegeons and interventional neuroradiologists worldwide choose treatment option according to this grading system. Aim of the study. To compare management decision of brain AVM with recommended treatment option according to estimated surgical risk by SMGS. . [...].

Introduction Singing Voice Handicap Index is a 36-item self-administered questionnaire (0-144 points) created for the assessment of singing voice related quality of life [1]. There was no specialised subjective method to measure singing voice problems in Lithuania. Aim To validate Lithuanian version of Singing Voice Handicap Index (SVHI-LT) Objectives 1. To evaluate psychometric properties of translated and culturally adapted SVHI-LT. 2. To assess discriminatory power of SVHI-LT. 3. To evaluate eligibility of SVHI-LT for self-assessment of voice related quality of life in Lithuanian-speaking singers. Methods Linguistic and cultural adaptation was made according to guidelines [2] including professional translators, re-translators, editors, ENT specialist committee and pilot study. After getting the final version of SVHI-LT, it was administered by 26 dysphonic (patients group) and 34 healthy singers (control group) who underwent multidimentional voice analysis. To check test-retest reliability subjects were asked to fill SVHI-LT for the second time after 2 weeks period. To assess concurrent validity, all participants completed the Lithuanian version of Voice handicap index (VHI) [3]. Content validity index at the item level (I-CVI) and at the scale level (S-CVI) were calculated. Internal consistency of SVHI-LT and its subscales (physical-P, functional-F, emotional-E) was measured using Cronbach’s alpha. Test-retest stability was assessed using Wilcoxon test and split-half reliability. Concurent validity between SVHI-LT and VHI was measured using Pearson correlation coeficient r. Discriminatory power was assessed by comparing mean rates of SVHI-LT between the groups (Student t-test). p < 0.05 level was considered to be statistically significant.[...].

Introduction Brain arteriovenous malformation (AVM) is a pathology with an abnormal connection between arteries and veins, bypassing the capillary system. The current treatment of AVMs includes surgical excision, stereotactic radiosurgery, and endovascular techniques but the gold standard of treatment is surgical extirpation of AVM nidus in order to completely reduce the risk of haemorrhage [1]. Spetzler-Martin grading system (SMGS) has been widely accepted to estimate treatment risks and predict the outcome of patients with intracranial AVM and currently, the majority of neurosurgeons and interventional neuroradiologists worldwide choose treatment option according to this grading system [2-4]. Aim To compare management decision of brain AVM with recommended treatment option according to estimated surgical risk by SMGS. Objectives 1. To select theoretical treatment options by counting SMGS indices and to compare with chosen ones. 2. To compare complications rate within chosen treatment options. 3. To identify complications rate in mismatched treatment option cases.Methods From January 2005 to February 2014 90 patients with AVM were treated in Neurosurgery department, LSMU University Hospital. In the final retrospective analysis 68 adult patients (48 men and 20 women, mean age 43.19 years (SD 14.1)) who had surgery alone or combined with endovascular treatment, endovascular treatment or observation alone, and whose angiograms were available in database, were included. Demographic data, management decision and complications (ischemic, haemorrhagic, new onset of epileptic seizures, cerebral oedema) were analysed from patients case files while patients’ neuroimaging (CT and/or MRI) and cerebral angiograms were interpreted together with experienced invasive radiologist and neurosurgeon. Neuroimaging findings included localisation of the AVM and presence of haemorrhage. In cerebral angiograms localisation and size [...].

Introduction Hearing loss for elderly may be less noticeable in a quiet office and in one-on-one conversation [1]. For screening purposes American Speech-Language-Hearing association recommends 10-item Hearing Handicap Inventory for the Elderly (HHIE) that can be given in less than 2 minutes and can help determine if audiologic evaluation is indicated [2]. Aim To validate Lithuanian version of Hearing Handicap Inventory for the Elderly (HHIE-LT). Objectives 1. To evaluate psychometric properties of translated and culturally adapted HHIE-LT. 2. To assess discriminatory power of HHIE-LT within patients and control groups and degree of hearing loss. 3. To evaluate usefulness of HHIE-LT for self-assessment of hearing loss in Lithuanian-speaking elderly population. Methods Linguistic and cultural adaptation was made according to guidelines [3]. After getting the final version of HHIE-LT, it was administered by 74 subjects (51 female, 23 male whose mean age was 75.5 ± 5.7 years). To all subjects otoscopy and pure tone audiogram was performed and bilateral auditory threshold ≥25dB (average in 0.5, 1, 2 kHz) was considered to be a value that separates patients group from people without hearing loss (control group). To check test-retest reliability subjects were asked to fill HHIE-LT for the second time after 2 weeks period. To assess concurrent validity, participants completed the Lithuanian version of a health-related quality of life questionnaire the MOS Short Health Survey (SF-36) with the same subscales as HHIE (socio/situational-S, emotional-E)[4]. Content validity index at the item level (I-CVI) and at the scale level (S-CVI) were calculated. Internal consistency was measured using Cronbach’s alpha. Test-retest stability was assessed using Wilcoxon test and split-half reliability. Concurent validity between HHIE-LT and SF-36 was measured using Pearson correlation coefficient r. Discriminatory power was asse[...].