[Mutation voice disorders conditioned by psychic factors]. / Zaburzenia glosu mutacyjnego uwarunkowane czynnikami psychicznymi.

The case of 17 year old boy with mutational falsetto conditioned by a complex of psychic factors particulary with personality disorders and strong emotional bond with his mother was described. Phonation exercises lowered the average voice pitch. The stable results of phoniatric rehabilitation is dependent on effectiveness of psychological therapy of the whole family. Acoustic voice analysis demonstrates objectively the results of rehabilitation.

[Binaural asymmetric sensorineural hearing loss in audiological practice]. / Ocena obustronnego asymetrycznego niedosluchu czuciowo-nerwowego w praktyce audiologicznej.

OBJECTIVES: To estimate binaural asymmetric sensorineural hearing loss in own material of patients treated in Dept. of Phoniatrics and Audiology. MATERIAL & METHODS: The retrospective analysis was performed on the group of 1816 patients hospitalized in 2008 due to hearing disorders. Asymmetry of hearing loss was classified on Margolis and Saly criteria in PTA, and in ABR results in children. CONCLUSIONS: Binaural asymmetric sensorineural hearing loss was found in 70 patients (3.9%). In a group of 46 differences of inter-aural threshold level in PTA were estimated on 21 to 30 dB. After audiological examination 14% of this patients were qualified for MRI investigation, in 2 (3%) of them acoustic neurinoma was found. The hearing aids fitting were performed in 44% of a group of 70 patients.

Estimation of influence of myofascial release techniques on esophageal pressure in patients after total laryngectomy.

In patients after total laryngectomy, increased tension in myofascial neck and arm areas might be observed. Via fascial continuity it has an adverse impact on the superior esophageal constrictor forming the "mouth of the oesophagus", which hinders learning of esophageal speech. The aim is to assess the effect of manual myofascial release techniques on esophageal pressure in patients after total laryngectomy. Forty patients (12 F, 28 M), aged 43-75 (mean 56.8 years), 9 months to 13 years (average 3 years) after total laryngectomy, 35 patients (87.5%) after neck lymph node resection, 38 patients (95%) after radiotherapy. Esophageal pressure was assessed using modified Seeman's method. Manual myofascial release techniques were applied within head, neck, arms, upper trunk and upper limb areas. Wilcoxon and Shapiro-Wilk's test was used for the purpose of statistical analysis. Statistically significant decrease of the mean esophageal pressure was observed after the physiotherapy treatment. The average pressure among the examined patients decreased from 37.9 to 26.6 mmHg. The application of myofascial manual techniques decreases esophageal pressure, thus allowing patients to learn esophagus speech at a faster pace.

[An influence of myofascial release techniques on the esophagus pressure for patients after total laryngectomy]. / Wplyw manualnych technik miesniowo-powieziowych na poziom cisnienia przelykowego u chorych po calkowitym usunieciu krtani.

UNLABELLED: The increase of patients after total laryngectomy myofascial neck and arms area tension might be observed. Via fascial continuity it has an adverse impact on superior oesophageal constrictor, forming the "mouth of oesophagus", which hinders learning oesophagus speech. THE AIM: The assessment of manual myofascial release techniques influence on the patients' oesophagus pressure after total laryngectomy. MATERIAL: 40 patients (12 F, 28 M), aged 43-75 (middle 56, 8 years), 9 months to 13 years (average 3 years) after total laryngectomy, 35 patients (87.5%) after neck lymph node's resection, 38 patients (95%) after radiotherapy. METHODS: The oesophagus pressure was checked by modified Seeman's method. Manual myofascial release techniques were applied within head, neck, arms, upper trunk and upper limbs area. Wilcoxon and Shapiro-Wilk's test was used for the purpose of statistical analysis. RESULTS: A statistical significant decrease of the mean of oesophagus pressure was observed after physiotherapy treatment. The average pressure among the examined group decreased from 37.9 to 26.6 mm Hg. CONCLUSIONS: The application of myofascial manual techniques decreased an oesophagus pressure which allows patients to obtain faster oesophagus speech.

[Further research on speech tests]. / Dalsze badania nad testami mowy utrudnionej.

INTRODUCTION: The purpose of speech audiometry is to extend the diagnostics of central auditory processes. First audiometric tests were monaural tests introduced in the fifties by Bocca and Calearo to diagnose Central Auditory Processing Disorders (CAPD). Monaural tests are characterized by low redundancy, which allows for deciphering a given word or phrase only if the amount of accessible information exceeds a required minimum. Until now, a new monaural filtered speech test has been drawn up at the Department of Phoniatrics and Audiology. The purpose of the research was to draw up and assess the effectiveness of monaural low redundancy tests, in which the acoustic signal has been compressed or noise has been added. MATERIALS AND METHOD: 35 people with normal hearing, aged 16-60, have been examined. The test material included: a compressed speech test, in which the speech signal has been accelerated by 25% with the use of Cool Edit Pro 2.0; the pauses between the words have not been shortened a speech-in-noise test, in which the noise has been added with the use of Cool Edit Pro 2.0. The signal/noise ratio has been set at the level of 10 dB. The examination has been conducted at three different volume levels: 25, 35 and 45 dB. CONCLUSIONS: Best results have been achieved at the volume level of 45 dB (above hearing threshold); There were differences in results at volume levels 25 dB and 35 dB in compressed speech test and at volume level 25 dB in speech in noise. Both tests have shown the influence of age on the test result which suggests undiagnosed CAPD among people (with normal hearing) aged over 55.

[Methods of larynx phoniatory function measurement in the Poznan University Department of Ear, Throat, Nose and Larynx Diseases between 1922 and 1939]. / Metody badania czynnosci fonacyjnej krtani w Klinice Otolaryngologicznej Uniwersytetu Poznanskiego w latach 1922-1939.

INTRODUCTION: Indirect laryngoscopy development and progress initiated in 1854 by the autolaryngoscopy of the famous singing voice teacher Manuel Garcia in ENT speciality is connected with the names of L. Tuerck and J.N. Czermak, the last one being called the father of laryngoscopy. In 1878 M. Oertel used for the first time stroboscopic light in indirect laryngoscopy. The perception of stroboscopic picture is based on the Talbot principle. OBJECT OF THE PAPER: Two apparatuses used for the evaluation of larynx function in the Poznan ENT Department before the II World War are presented:--Polylaryngoscop enabling evaluation the indirect laryngoscopy simultaneously by several individuals.--Mechanical stroboscop of Oertel type with perforated disc moved by electrical engine. CONCLUSION: For 130 years laryngostroboscopy belongs to the basic examination methods of larynx phonatory function.

[Polish language dychotomic tests for speech audiometry Part 2: A study of people with normal hearing from various age groups]. / Testy utrudnione w audiometrii mowy dla jezyka polskiego (czesc II). Badania osób z prawidlowym sluchem w róznych grupach wiekowych.

INTRODUCTION: Evaluation of the objective results in the clinical examination of central auditory disorders requires the use of reliable language tests which provide the means for the estimation of patients' audio-verbal communicative skills. MATERIALS AND METHODS: The authors present a new set of more difficult language tests in Polish, including a filtered speech test, numeral and verbal dichotic tests and the normal Calearo test. The tests were evaluated on a group of people with good hearing from various age groups. CONCLUSIONS: The presented tests are the only existing ones created for the Polish language which expand the diagnostic possibilities in the case of central auditory processing disorders. It was found that there is a right ear predominance in dichotic tests, which grows together with the patient's age. This observation can be very beneficial in practice, allowing for hearing aids to be better fitted.

[Dychotomic tests in Polish for speech audiometry part 1: preparing material for the tests]. / Testy utrudnione w audiometrii mowy dla jezyka polskiego Czesc I: przygotowanie materialu testowego.

INTRODUCTION: Dychotomic tests in speech audiometry are extremely beneficial, especially in diagnosing central auditory processing disorders. MATERIALS AND METHODS: Basing on new articulatory lists (NLA-93), the authors have prepared a new set of language tests, including filtered speech test, numeral and verbal dichotic tests and Calearo test. CONCLUSIONS: The phonetic characteristics of the tests are presented, with special attention paid to their phonetic balance.

[Subjective assessment of voice functions among teachers taking part in the rehabilitation program]. / Subiektywna ocena czynnosci glosowej u nauczycieli uczestniczacych w programie rehabilitacyjnym.

INTRODUCTION: In daily phoniatric practice, apart from laryngoscopy, another simple and useful method of examining the voice organ is perceptual voice assessment based on the GRBAS scale. An extension to this examination can be the Voice Handicap Index test (VHI). MATERIALS AND METHODS: 79 female teachers taking part in a 7-week-long rehabilitation course on voice emission techniques. Before and after the course the participants were subject to phoniatric examination including laryngovideostroboscopy, GRBAS scale assessment and determining the voice handicap index (VHI). RESULTS: After the course, a substantial improvement has been observed in voice emission, perceptual assessment and the VHI test. It has been observed that there is a statistically significant correlation between GRBAS and VHI results and mean phonation time (MPT) measured before and after the course. CONCLUSIONS: The VHI test should be included in complex analysis of the effects of intensive rehabilitation.

[The local and sensual conditions of delay of voice breaking in adolescent boys]. / Uwarunkowania miejscowe i zmyslowe przedluzonej mutacji.

Disorders of voice breaking in adolescent boys (mutational dysphonia) could be a result of local, hormonal, neuropsychiatric or sensual factors. The aim of this paper was the voice assessment of three subjects with incomplete mutation with particular additional factors, disturbing hearing, voice and speech: like hearing loss, hyperfunctional childhood dysphonia and speech dysfluency. Diagnostics included complete phoniatric examination with perceptive estimation, videostroboscopy and acoustic voice analysis, done before and after treatment. Rehabilitation process results were well seen in perceptive and objective voice analysis except significant improvement of fundamental frequency average. Analysis of incomplete mutation etiological factors need special attention due to coexist with another voice, speech and hearing disorders, which undergo with high tension of voice organ muscles or with the lack of phonation auditory feedback.

[The characteristic of vocal fold molecular structure]. / Charakterystyka budowy molekularnej faldu glosowego.

INTRODUCTION: The authors present the layer structure of the vocal fold (by Hirano) indicating at the same time its clinical usefulness in laser chordectomy. MATERIALS AND METHODS: The authors describe the structure of the basement membrane sphere, i.e. the connection between the epithelium and the superficial layer of lamina propria, and the molecular structure of the extracellular matrix of mucosa. RESULTS: The biomechanical significance of fibre proteins and the extracellular matrix is emphasized with special attention paid to hialuronic acid and fibronectin. CONCLUSIONS: Knowing the ultra-structure of the epithelium mucosa connection helps in understanding the mechanism of F0 production. The disorders in cooperation of the biomolecules of lamina propria of the vocal folds can influence the biomechanics of phonation.

[The teachers health damage and pension related to occupational voice disease]. / Uszczerbek na zdrowiu i renta z tytulu choroby zawodowej narzadu glosu u nauczycieli.

The current regulations allow in special cases for the acknowledgement of the occupational disease among teachers who suffer from voice disorders. The physician who acts as the adjudicator in ZUS (National Insurance System) usually consults a phoniatrician and determines the percent of the permanent or long-term health damage, which can vary between 10-40%. The aim of the paper was to analyze the evidence which is taken into consideration while determining the percent of health damage and granting the occupational disease pension. The authors present proposition in detail the rules which govern the process of health damage calculation due to advancement of voice disorders, which can be very useful to adjudicating physicians in government and commercial insurance companies.

[Voice disorders in recurrent laryngeal granuloma dependend on GERD]. / Zaburzenia glosu w nawrotowym ziarniniaku krtani w przebiegu GERD.

The voice disorders in a case of recurrent laryngeal granuloma with chronic gastroesophageal reflux was described. There was emphasized necessity of complex treatment pharmacological and phoniatric, as well as there were pointed out some indications of microsurgery.

[Benign paroxysmal positional vertigo in the own material]. / Lagodne napadowe polozeniowe zawroty glowy w materiale wlasnym.

INTRODUCTION: The complaint of dizziness can be caused by a variety of disorders affecting central or peripheral vestibular system. Benign paroxysmal positional vertigo BPPV is the most common cause of vertigo. It is a syndrom characterized by short-lasted episodes of true vertigo, induced by a rapid head position change and associated with a positional, transient nystagmus. It is classically identified by the Dix-Hallpike test. Vestibular and audiology function tests are usually normal. Patient is succesfully treated with physical maneuvres (Canalith Repositioning Procedure CRP). MATERIAL AND METHODS: This raport presents eight patients (four are described in details) suffered from BPPV-PSC, hospitalized in the Department of Phoniatric and Audiology, Poznan University of Medical Sciences. Methods include laryngologic examination, audiology and vestibular tests, Dix-Hallpike'a maneuver. RESULTS: All patients presented characteristic history and results of performed diagnostic tests. The efficacy of physical maneuvers were confirmed. CONCLUSIONS: BPPV is usually easy to diagnose and physical maneuvers are very effective.

[Bilateral internal laryngocele with open nasality--report of a case]. / Obustronne wewngtrzne laryngocele ze wspólistniejacym nosowaniem otwartym.

Laryngocele is an abnormal saccule dilatation of the ventricle in direct communication with the laryngeal lumen. It is usually filled by air and mostly asymptomatic. This case is reported due to its rarity. A bilateral internal laryngocele with open nasality in 66-year-old man is described. Patient has been observed for 8 years with stable course of the disease and good general condition. Because the squamous cell carcinoma is known to occur in association with laryngocele necessity of control evaluation is very important. The etiology, classification, evaluation is discussed.

[The auditory late potentials (P300, MMN) in central speech disorders in children]. / Pózne potencjaly wywolane (P300, MMN) w osrodkowych zaburzeniach mowy u dzieci.

The aim of this paper was introduction of preliminary study of late auditory evoked potentials P300 and MMN insome central communication process disorders. The investigations were performed in the group of three children with development dysphasia and pseudobulbar dyzarthria. The registration of endogenic late cognitive potentials was performed using the alternate application of stimulus of pure tones 1 and 2 kHz, and logatoms (da)-(ga). In all patients the normal hearing threshold and the unilateral disturbances in registration of P300 and mismatch negativity (MMN) were found.

[Contraindication for cochlear implantation in Wildervanck's syndrome]. / Przeciwwskazania do wszczepu slimakowego w zespole Wildervancka.

A case of 4-year-old boy with Wildervanck's syndrome and associated profound sensorineural hearing loss is presented. The child was disqualified from cochlear implantation following the CT scan of petrous pyramids which revealed inner ear malformation. The authors emphasize role of CT imaging in the management of profound sensorineural hearing loss in children before final qualification for cochlear implantation.

[Complex voice assessment--Polish version of the Voice Handicap Index (VHI)]. / W sprawie kompleksowej oceny glosu--wlasna modyfikacja testu samooceny niesprawnosci glosu (Voice Handicap Index).

The aim of this work was to present own modification of Jacobson's The Voice Handicap Index, the self-estimation scale of the voice as a one part of the complex voice evaluation. The VHI contains three groups of questions of physical, emotional and functional subscales, which specify complaints during phonation scored in 4 points (0-4). The presented our own modification of the VHI may be useful in everyday clinical practice.