Andrzej Obrębowski

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.

Metody badania czynności fonacyjnej krtani w Klinice Otolaryngologicznej Uniwersytetu Poznańskiego w latach 1922–1939

Summary 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.

Zaburzenia głosu mutacyjnego uwarunkowane czynnikami psychicznymi

Summary 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.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.

Audiological assessment of unilateral deafness

Unilateral deafness constitute medical (aetiological diagnosis, treatment, hearing aid fitting) and social problems (no certification of disability). Following audiological examinations were performed in the study: pure tone audiometry (PTA), impedance audiometry, auditory brainstem responses (ABR), otoacoustic emissions (OAE), as well as balance, taste, examinations and electric sensitivity of the acoustic nerve. In cases of tinnitus the parameters of its character were done. All of our patients underwent X-ray investigations, i.e. ear X-ray by Schu¨ller and Stenvers methods, computerized tomography or magnetic resonance imaging. In some cases phoniatric and logopaedic examinations were performed. For aetiological diagnosis electrophoresis and immunological test (IgG and IgM against mumps) were carried out. The results were presented in two groups of patients with sudden and those of long lasting progressive unilateral deafness. Some of the patients were pharmacologically treated before the evaluation. It is concluded that the statistic analysis could be a basis for the management and prognosis of the unilateral deafness.

Geruch und Geschmack bei angeborener Nebennierenrindenhypertrophie

Bei 12 Kindern im Alter von 5 bis 18 Jahren mit angeborener Hypertrophie der Nebennierenrinde wurden sowohl in quantitativen als auch qualitativen Untersuchungen bei mehr als der HAlfte sehr niedrige Gerachwahrnehmungsund Gerucherkennungsschwellen bei gleichzeitig niedriger Schwelle der Geschmacksempfindung festgestellt. Die Ergebnisse deuten auf eine Uberempfindlichkeit des Geruchs- und Geschmackssinnes bei angeborener Hypertrophie der Nebennierenrinde hin.

Pourazowe zmiany krtani i głosu u dzieci

Summary The larynx trauma – this is about 7% of all cases of post traumatic changes in human body. The most useful classification from clinical point of view is external and internal traumas. In children even due to relative resistance of larynx on external trauma, they are not rare. Material of our paper consists children of age 12, 11 and 16 after various laryngeal trauma. Respectively there were traumatic changes after multiple bronchoscopy and lungs cysts operation, laryngeal malformation after dog bits in neck region and larynx trauma in car accident. In all cases the first symptom was dyspnea and then dysphonia. The purpose of the paper was to introduce the results of voice rehabilitation in specific post traumatic structural malformations of larynx. The voice estimation based on perceptual and objective acoustic analyses in comparison on glottis morphology. There was found that the voice quality not always depends on extension and degree of larynx damage.

Problemy psychologiczne w rehabilitacji chorych po operacjach całkowitego usunięcia krtani

Summary Even suspicion of cancer can cause severe stress reaction on all fields of human activity. In a group of patients with larynx cancer there is additionally a luck of possibility to communicate with loud voice. That why the medical team supposed to explain that the total resection of the larynx will not deprive the speech, and that physiological generator of voice pure tone can be replaced by esophageal voice and speech. Psychological support for patients qualified for total laryngectomy has to be applied just immediately after first diagnosis of cancer.

Ocena obustronnego asymetrycznego niedosłuchu czuciowo-nerwowego w praktyce audiologicznej

OBJECTIVESnTo estimate binaural asymmetric sensorineural hearing loss in own material of patients treated in Dept. of Phoniatrics and Audiology.nnnMATERIAL & METHODSnThe 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.nnnCONCLUSIONSnBinaural 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.Summary 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.

Wpływ manualnych technik mięśniowo-powięziowych na poziom ciśnienia przełykowego u chorych po całkowitym usunięciu krtani

Summary 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 nodes resection, 38 patients (95%) after radiotherapy. Methods The oesophagus pressure was checked by modified Seemans method. Manual myofascial release techniques were applied within head, neck, arms, upper trunk and upper limbs area. Wilcoxon and Shapiro-Wilks 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.UNLABELLEDnThe 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.nnnTHE AIMnThe assessment of manual myofascial release techniques influence on the patients oesophagus pressure after total laryngectomy.nnnMATERIALn40 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 nodes resection, 38 patients (95%) after radiotherapy.nnnMETHODSnThe oesophagus pressure was checked by modified Seemans method. Manual myofascial release techniques were applied within head, neck, arms, upper trunk and upper limbs area. Wilcoxon and Shapiro-Wilks test was used for the purpose of statistical analysis.nnnRESULTSnA 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.nnnCONCLUSIONSnThe application of myofascial manual techniques decreased an oesophagus pressure which allows patients to obtain faster oesophagus speech.

Dalsze badania nad testami mowy utrudnionej

INTRODUCTIONnThe 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.nnnMATERIALS AND METHODn35 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.nnnCONCLUSIONSnBest 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.Summary 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.