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Introduction@#Khuumii (throat singing) is a unique form of art derived from the nomadic population of Central Asia, producing two or more “simultaneous” sounds and melodies through the organ of speech. @*Material and Methods@#The aim of the study is to identify the anatomical structures involved in the formation of khuumii and the features and patterns of their functions and compare each type of khuumii as performed by Mongolian people. A total of 60 participants aged 18-60 years (54 men and 6 women) were selected by non-random sampling method using cross-sectional study. Statistical analysis was performed using SPSS 23 software using questionnaires, X-ray, endoscopy, sound research method, and general blood tests. @*Results@#90.7% of the khuumii singers were male and 9.3% were female. The average height of the participants was 172.91±0.93 cm (arithmetic mean and mean error), average body weight was 77.53±2.46 kg, and body mass index was 25.93±5.31 respectively. Heart rate was 92.19±20.71 per minute prior to khuumii while 133.19±19.09 after performing khuumii and 85.81-98.56 at 95% confidence interval. In terms of ethnicity (ethnographically), the Khalkh were the largest ethnic group (72.1%), followed by Bayad, Buryatia, Darkhad, Torguud, and Oirat (2.3%), respectively. 60.5% of the participants were professional khuumii singers who graduated from relevant universities and colleges. The process of Khuumii was recorded by X-ray examination, and laryngeal endoscopy evaluated the movement of true and false vocal chords, interstitial volume, movements of epiglottis and arytenoid cartilage, and mucosa. Khuumii increases the workload of the cardiovascular system by 70-80%. Furthermore, the sound frequency is 2-4 times higher than that of normal speech, and sound volume is 0.5-1 times higher. 95.3% of throat singers did not have a sore throat, 88.4% did not experience heavy breathing, and 74.1% had no hoarseness. During the formation of khuumii sound, thoracic cavity, diaphragm, and lungs regulate the intensity of the air reaching the vocal folds, exert pressure on the airways and vibrate the sound waves through air flows passing through the larynx and vocal folds. Mouth-nose cavity as well as pharynx are responsible for echoing the sound.@*Conclusion@#It is appropriate to divide khuumii into two main types according to structural and functional changes in the organs involved; shakhaa and kharkhiraa. Khuumii, the “Human music” originating from the people of Altai Khangai basin by imitating the sounds of nature with their own voice in ancient times, spread all over the world from Mongolia and it is proposed to classify khuumii into two main types of shakhaa and kharkhiraa in terms of structural involvement and functionality.
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@#This study investigates cochlear implant surgical and Audio Verbal Therapy (AVT) practice patterns of patients with hearing loss (HL) based on data of “Aid” ENT Clinic and Speech Therapy Unit of School of Dentistry, Mongolian National University of Medical Sciences (MNUMS) between 2009-2018. Our aim was to describe and collect related data on surgical interventions, using cochlear implant for patients with severe hearing loss and their involvement in the AVT sessions. Hospital based registry data by audiologistwere retrospectively investigated. Descriptive statistics are used to describe the basic features of the data in the study. In total 78 patients had cochlear implantation surgery with chronological age between 2 months and 55 years. From total subjects 46 (54.59%) were male and 32 (33.41%) female. The distribution of etiology for the hearing loss showed that the majority of hearing loss 47 (60%) had due to infectious diseases, other diseases or injury, 25 (32%) congenital and 6 (8%) unknown causes. Documentation and proper registration is essential for better outcome of cochlear implantation surgery, especially teamwork of speech therapist doing AVT and audiologist in charge of fitting. Furthermore, epidemiological studies are important for evaluation and monitoring of interventions by every specialists included in the treatment team.
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@#The main goal of this study is to examine the development of auditory perception performances of a cochlear implanted child who receive auditory verbal therapy. Present study included a child with prelinguistic hearing loss who received cochlear implant at the Department of ENT, 1st State Central Hospital and enrolled in Auditory Verbal Therapy (AVT) in the Speech Therapy Unit of “ Aid” Clinic. This hearing impaired child participated in auditory verbal therapy with their mother and/or father for 5 months, and the family was given training programs to apply at home after each therapy session. The auditory perception performances of a child were evaluated before implantation and after: twice every week in total 32 Audio-Verval Therapy sessions were performed with the help of Medel LittlEars Auditory Questionnaire, LIP (Listening Process Profile), Ling’s Five Sound Test, the Multiple Frequency Animal Sound Test (mFAST) and MTP (Monosyllable and Polysyllable Test). The auditory perception performances of a child joining auditory verbal therapy programs increased after 5 months of implantation. According to the Ling’s test all 5 sounds are determined (20-60dB) in 1m distance, but discrimination is observed in frequency range between 40-60 dB for sounds “A”, “U” and “M”. Parents active participation as well as full attendance in the AVT treatment shows progress in auditory development of a child. Furthermore evaluation and data analysis is needed.
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@#BACKGROUND Congenital and acquired hearing loss considered as the most common disability. According to the WHO report, 360 million people worldwide have disabling hearing loss, and 32 million of these are children. Severe to profound sensorineural hearing loss can be treated successfully with cochlear implants. Post implant Auditory Verbal Therapy/ Hearing Implant Rehabilitation is essential for the progress and better outcome. Multidisciplinary team approach, including ENT, audiologist, speech therapy, social worker, coordinator, caregiver /parent is required. The first clinical speech therapy department in Mongolia was established by the School of Dentistry, MNUMS based at the Maxillofacial Surgery Department of the MCNHC in 2006 (G. Ariuntuul, B. Bulgan, U. Azzaya). Where as the very first Cochlear Implanted child in Mongolia was received the surgery and audiology support by A. Ulziibayar, L. Byambasuren, B. Misheel, B. Narantya and the hearing implant rehabilitation treatment successfully conducted by the abovementioned speech team in 2009. Aim: To analyze current situation on speech therapy intervention for patients with hearing loss and deafness. METHODS Retrospective hospital data were collected based on the School of Dentistry, Speech therapy department between January, 2009- February, 2017. In total 70 patients’ information were retrieved for the study. Descriptive method is used for statistical analysis. RESULTS Out of 70 patients, attended speech therapy sessions 38 (54%) were males, 32 (46%) were females; where as 21 (30%) had congenital deafness and 28 (40%) acquired; 21 (30%) patients with hearing loss not known their causes of deafness. From the total of 28 (100%) cases with acquired hearing loss/deafness 11 (39%) patients cause of deafness is due to complication from infectios disease: meningitis.
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In modern society there is an increasing demand for oral communication in many professions. Professional voice users aren’t limited to teachers, ministers, salesmen, telemarketers, telephone operators, actors, singers, radio/TV announcers and attorneys. Problems reported by professional voice users are varied and may include hoarseness, voice breaks or cracks, voice loss, weak voiceand vocal fatigue. There are no studies done about the professional voice users in Mongolia. The purpose of this research that was to examine loading effect of work and additional loading factors. We were studied about comparison between normal groups and voice changes groups. Ninety seven professional voice users participated in this study. Half had singers group and half were found to haveteachers group. We used to the voice handicap index (VHI ) score and videolaryngoscopy and other general questionnaire.We studies voice change of the 97 professional voice users. We diagnosed voice disoeders by videolaryngoscopy and voice handicap index. We collected the data base in SPSS 22 and Microsoft excel programs.Major risk factor for voice change was use hormonal medicine. From 97 patients were predominantly diagnosed disease 14,4% reflux laryngit, 15.5% vocal fold nodule, 23.7% acute laryngit. Most of the patients had mild levels changes of voice handicap index.Voice disorders are common in professional voice users. So steroid use increase the risk of voice disorder in professional voice users.
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We present the fi rst 2 cases of cochlear implantation in Mongolia using “SONATA” type implant of “MED-EL” Company, Austria. CASE 1: A six years old, female had been diagnosed with bilateral congenital profound hearing loss and had been fi tted with hearing aids for 5 years and received little benefi t from her hearing aids and developed very poor speech and language, used lip reading and have had vocabulary of approximately 10 words. A radiological evaluation showed normal cochlea and auditory nerve. Cochlear implant team including speech therapists and audiologists based on the informed consent of patient’s parent decided that family able to participate in follow-up, speech habilitation programme. Patient implanted with SONATA of MED-EL on 4 August, 2009. Electrodes were inserted fully. After 10 days of switch on of the speech processor the patient showed signs of initial hearing of loud sounds. After 5 months of Auditory Verbal Therapy the vocabulary increased up to 50 words. Hearing, cognition and responses are increasing simultaneously. CASE 2: A 2 years old female. Congenitally deaf in both ears. Fitted with hearing aid for 3 months before the surgery and there was no benefi t from hearing aid. Physically and mentally healthy. Patient implanted with SONATA of MED-EL on 4 August, 2009. Electrodes were inserted fully. On 25th days of switching on of speech processor the patient showed initial hearing of loud sounds. Currently, after 5months of treatment her vocabulary is 2 short words and can recognize 4 syllabeles. She is very active, repeats actions and has open nature, feels comfortable with CI.