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BackgroundVocal fold nodules are a common cause of pediatric dysphonia. The aim of the study was to assess the acoustic structure of the voice in children with vocal fold nodules and investigate the relationship between objective and subjective measures.Material and methodsThe study group consisted of 223 children, aged 7 to 12 years with normal hearing. The control group included 213 children. All children underwent ENT and phoniatric examination including laryngovideostroboscopy (LVS), assessment of voice on the GRBAS perceptual scale, and acoustic analysis (spectrographic analysis using the Multi-Dimensional Voice Profile).ResultsIn children with vocal fold nodules the average perceptual score for their voice was G1R1B0A0S2. No statistically significant effect of the child’s sex or age on the values of the MDVP parameters was found. The acoustic structure of the voice of children with childhood dysphonia and vocal fold nodules differed significantly from the acoustic structure of those in the control group. A relationship between GRBAS features and MDVP analysis was found.ConclusionsVoice acoustic analysis is a valuable tool for assessing voice quality in children. The analysis can identify deviations from normal values that the human ear is unable to pick up.

This article presents an overview of information on the development of voice, based on a detailed analysis of the literature. The data demonstrate voice abnormalities in individuals with hearing impairment as compared to individuals with normal hearing. Many researchers believe that the main factor leading to voice abnormalities among hearing-impaired individuals is incorrect auditory feedback resulting from higher hearing thresholds. This lack of feedback leads to abnormal encoding of neuronal patterns in cortical regions of the brain, which results in a disrupted control of internal and external laryngeal muscles.

BackgroundAccording to the literature, the rate of laryngeal paralysis after thyroid surgery is as high as several percent. For oncolog-ical operations the rate can reach 20%. The return of laryngeal function depends on the degree of nerve damage. Surgical procedures are required to increase the likelihood of nerve function recovery. Three methods of phonosurgery are currently used. The first is based on injecting auto or alloplastic materials into the vocal fold. The second interferes with the skeleton of the laryngeal cartilages; according to the Isshiki clas-sification, it includes type I thyreoplasty (medialisation thyreoplasty), optionally with complementary arytenoid adduction. The third method reconstructs the laryngeal nerves. Combinations of the three methods are increasingly used. Conservative treatment including phoniatric voice rehabilitation should be started as early as possible.Case reportThe paper presents a case report of a patient after thyroid surgery due to papillary carcinoma, complicated by bilateral laryn-geal paralysis and aphonia.ConclusionsFunctional Voice Therapy started just after healing of the postoperative wound in the neck eliminated abnormal compensatory mechanisms of phonation. Reconstruction of the laryngeal nerves is an opportunity to quickly return laryngeal function and prevents unwanted secondary functional mechanisms within the vocal organ.

BackgroundThis study presents the case of a 32-year old woman who presented with severe dysphonia. She had experienced voice problems since childhood.Material and MethodsThe patient underwent otolaryngological and phoniatric examination including videolaryngostroboscopy (VLS), perceptual evaluation (GRBAS scale), and acoustic analysis of voice (MDVP software). Microsurgery was performed using a CO2 Acupulse laser (Lumenis) with AcuBlade micromanipulator.ResultsVLS revealed glottal incompetence, an intracordal mass on the right vocal fold, and capillary ectasia on the superior surface of the right vocal fold. Atrophy was seen along the free edge of the left vocal fold. GRBAS and MDVP revealed significant voice disturbances. The patient was referred for direct microlaryngoscopy. Initial inspection of the vocal folds showed bilateral intracordal mass and sulcus vergeture. Using a microflap technique the fibrous mass was removed. For the sulcus vergeture a surgical technique based on a concept by Cornut and Bouchayer and modified by Remacle was used. Complementary hyaluronic acid (Surgiderm 24XP) was injected to correct the left vocal fold volume. Stroboscopic evaluation performed 3 months postoperatively showed significant improvement of glottis closure and vibratory parameters. Perceptual and objective voice assessment revealed improvement in the acoustic structure of the voice after surgeryConclusionsCoexistence of bilateral sulcus vergeture and bilateral fibrous mass is a very rare occurrence. The preoperative diagnosis is often not obvious. Severe voice disturbances make surgery the first treatment option in such cases.

BackgroundPartial deafness (PD) is a condition in which normal hearing is preserved in the low frequency range, while severe to profound hearing loss is observed in the middle and high frequency ranges. The aim of this study was to assess the acoustic structure of the voice in children considered for partial deafness treatment (PDT).Material and MethodsThe material included 127 children aged from 5 to 12 years old. The study group included children with partial deafness (PD). Depending on age, patients in the study group were divided into 2 groups. The first included 40 children aged 5–6 years, and the second consisted of 44 school-age children aged 7–12 years. The control group included 20 healthy normally hearing children aged 5–6 years and 23 healthy, normally hearing children with clear voices, aged 7–12 years. Children’s voices were assessed subjectively by the physician and objectively with the use of a digital CSL KAY Multidimensional Voice Profile analyser (MDVP). The sustained vowel “a” was used for analysis.ResultsAcoustic features of PD vs. normally hearing children were different. Statistically significant parameters differentiating voices in the group of younger children were fundamental frequency (Fo); shimmer, a parameter describing changes in amplitude (ShdB); and noise-to-harmonic-ratio (NHR). In the group of older children more acoustic parameters characterizing voices of PD children were defined. They included fundamental frequency (Fo); fundamental frequency variation (vFo); amplitude change (vAm, sAPQ); noise-to-harmonic-ratio (NHR); and voice tremor (FTRI).ConclusionsThe acoustic structure of the voice in children with partial deafness is different from that in children with normal hearing.