Waldemar Wojnowski

Affective temperament in women with functional aphonia.

OBJECTIVES The aim of the present study was to assess the affective temperament in women with functional aphonia. STUDY DESIGN Cross-sectional. METHODS Forty-one women with functional aphonia underwent an examination of affective temperament by means of the Temperament Evaluation of Memphis, Pisa and San Diego Autoquestionnaire. RESULTS Compared with the reference group, women with functional aphonia show significantly higher rates of depressive and anxious temperament. CONCLUSIONS The results of the present study are concordant with the previous findings, indicating elevated levels of depressive and anxious symptoms in aphonic patients. Implications for the therapy of functional aphonia as well as considerations for further studies are discussed.

Phenotype-genotype discordance in congenital malformations with communication disorders resembling trisomy 18 (Edwards syndrome)

Patient: Female, 6 Final Diagnosis: Phenotype-genotype discordance in congenital malformations with communication disorders resembling trisomy 18 (Edwards syndrome) Symptoms: — Medication: — Clinical Procedure: — Specialty: Otolaryngology Objective: Congenital defects Background: Communication process disorders are very frequent in rare cases of chromosomal aberrations (deletions, insertions, and trisomies) such as Down syndrome (trisomy 21), Turner syndrome, Edwards syndrome (trisomy 18), or Patau syndrome (trisomy 13). Sometimes phenotype may delusively correspond to the characteristic features of a given syndrome, but genotype tests do not confirm its presence. Case Report: We present the case of a 6-year-old girl admitted to the Clinic of Phoniatrics and Audiology for the assessment of communication in the course of congenital malformations with phenotype characteristic for trisomy 18 (Edwards syndrome). Immediately upon birth, dysmorphic changes suggesting trisomy 18 (Edwards syndrome) were observed, but trisomy 18 was excluded after karyotype test results were normal (46, XX). Conclusions: Disturbed articulation was diagnosed: deformed linguo-dental and palatal sounds, interdental realization with flat tongue of the /s/, /z/, /c/, /dz/, /ś/, /ź/, /ć/, /dz/ sounds (sigmatismus interdentalis). Hearing loss was confirmed.

Zastosowanie manualnych technik fizjoterapeutycznych w rehabilitacji dysfonii pourazowej

UNLABELLED As a result of laryngeal injures an abnormal phonation is frequently observed. It is the consequence of structural and functional changes of the laryngeal tissues directly and indirectly responsible for the voice emission. Physiotherapy enables the normalization of the tension and function of the anatomical structures changed after trauma. THE AIM OF THE STUDY Presentation of the results of the physiotherapy and voice rehabilitation treatment established for patient with voice disorders, occurred after cranio-cerebral trauma. MATERIAL AND METHODS The 47 year old man two years after cranio-cerebral trauma was presented, which voice was hoarse, produced with a strong neck and shoulder girdle muscle tension. Phonation time was significantly shortened. During the manual examination the abnormal of mobility, range of movement and soft tissue tension in neck, head and upper trunk area has been observed. The systematic rehabilitation program was started 2 years after injury and it was continued for four months. The individual program contains physiotherapy, osteopathic and speech therapy treatment. The phoniatric examination was performed before and after rehabilitation RESULTS After four months of treatment and after self-therapy exercises the significant changes were observed. Patients voice became no more strain, but stronger and socially effective. CONCLUSIONS The application of an individual therapy which contained osteopathic manual muscle-fascial techniques allows a subjective and objective improvement of voice in a examined patient. This procedure is an effective complement to logopedic and phoniatric therapy for patients after trauma of the larynx.Summary As a result of laryngeal injures an abnormal phonation is frequently observed. It is the consequence of structural and functional changes of the laryngeal tissues directly and indirectly responsible for the voice emission. Physiotherapy enables the normalization of the tension and function of the anatomical structures changed after trauma. The aim of the study Presentation of the results of the physiotherapy and voice rehabilitation treatment established for patient with voice disorders, occurred after cranio-cerebral trauma. Material and Methods The 47 year old man two years after cranio-cerebral trauma was presented, which voice was hoarse, produced with a strong neck and shoulder girdle muscle tension. Phonation time was significantly shortened. During the manual examination the abnormal of mobility, range of movement and soft tissue tension in neck, head and upper trunk area has been observed. The systematic rehabilitation program was started 2 years after injury and it was continued for four months. The individual program contains physiotherapy, osteopathic and speech therapy treatment. The phoniatric examination was performed before and after rehabilitation Results After four months of treatment and after self-therapy exercises the significant changes were observed. Patients voice became no more strain, but stronger and socially effective. Conclusions The application of an individual therapy which contained osteopathic manual muscle-fascial techniques allows a subjective and objective improvement of voice in a examined patient. This procedure is an effective complement to logopedic and phoniatric therapy for patients after trauma of the larynx.

Szumy uszne jako objaw zespołu Arnolda-Chiariego☆☆☆

The Arnold-Chiari malformation is very rare hindbrain abnormalities characterized by herniation of the hindbrain through the foramen magnum. It usually does not present until adulthood, and then its symptoms may be varied and subtle. Patient 49 years was diagnosed in Foniatrics and Audiology Clinic because of tinnitus in left ear lasting 3 months. She underwent audiological diagnostic, that did not reveal any abnormalities, except for electrogustometry and hyporeflexia of stapedial reflex and labyrinth on the left side. In MRI scan we have noticed hindbrain abnormalities characteristic for Chiari type I malformation. Treatment consisted of immediate supportive care as needed but without surgical decompression, which was found unnecessary.The Arnold-Chiari malformation is very rare hindbrain abnormalities characterized by herniation of the hindbrain through the foramen magnum. It usually does not present until adulthood, and then its symptoms may be varied and subtle. Patient 49 years was diagnosed in Foniatrics and Audiology Clinic because of tinnitus in left ear lasting 3 months. She underwent audiological diagnostic, that did not reveal any abnormalities, except for electrogustometry and hyporeflexia of stapedial reflex and labyrinth on the left side. In MRI scan we have noticed hindbrain abnormalities characteristic for Chiari type I malformation. Treatment consisted of immediate supportive care as needed but without surgical decompression, which was found unnecessary.

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.

Usefulness of low redundancy speech tests with dyslexic children

Abstract Objectives: Developmental dyslexia in children can affect auditory and linguistic skills. Due to the impairment of hearing discrimination, attention, memory and perception, dyslexia causes the inability to process and interpret linguistic and verbal information effectively. Standard audiological examination is much less useful than low redundancy speech tests and electro-physiological examination, which are the only objective measures of central auditory processing. The aim of the study was to assess the usefulness of low redundancy speech tests and dichotic tests in the diagnosis of developmental dyslexia in children. Methods: Ten children aged 7–15 years were tested by a dichotic numeral test, a dichotic verbal minimal-pair test, and a Calearo test. Results: The experiments demonstrated that the dyslectic group achieved worse results in the above tests compared to the control group. This suggests information exchange disorders between the hemispheres, a lack of synchronization of acoustic perception in dichotic tests, and damage of the structures responsible for central auditory processing in the dominating hemisphere. Conclusions: The results of our study confirm the existence of information exchange disorders between the hemispheres and the lack of synchronization of acoustic perception in dichotic tests, where the signal is presented to both ears simultaneously. Much worse results in low redundancy tests reveal, moreover, damage of the structures responsible for central auditory processing in the dominating hemisphere. Altogether, this research has proved the usefulness of the conducted tests in the diagnostics of central auditory processing disorders in patients with dyslexia.

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.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.