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Introduction: Profound hearing loss significantly affects the quality of life of deaf people as well as their families. Observation of the benefit from the use of cochlear implants in deaf patients allows to assess the success of treatment with this method and its impact on the quality of life of these patients. The aim of this study was to determine the quality of life in patient after the cochlear implantation in the material of Department of Phoniatrics and Audiology of the Medical University in Poznań. Material and methods: The study involved implanted patients who voluntarily joined to the project entitled "Observational study of the implanted patient (Cochlear-IROS)". It has a prospective character, it is an international and long-term study, covering the observation of patients up to three years after implantation. Standardized HUI and SSQ questionnaires were used. 70 patients were included in the analysis, the mean age at the time of the cochlear implantation was 47.6 years. In the research group there were 33 men and 37 women. In the whole group, the patients' age at implantation was at least 18 years, max. 80 years. Results: The results of the SSQ questionnaire, which deals with the self-assessment of hearing ability in everyday situations, indicate that in the subjective assessment of patients one year after surgery the speech hearing improved by 77%, spatial hearing by 84%, and the quality of hearing by 49%. The general quality of life before the first connection of the sound processor according to the HUI questionnaire, the patients rated at 0.49 (0-1 scale, where 0 - corresponds to the death condition and 1 - full health). After one year from the implantation, this rating increased to 0.56. Conclusions: The implantation of the cochlear implant significantly increases the patient's quality of life, its physical and emotional functioning. Statistically significant better self-assessment of patients mainly concerned hearing speech and spatial hearing - especially after 1 year of connecting the speech processor.

Mechanical debulking of laryngeal papillomas is associated with voice disorders due to impairment of the vocal fold’s mucosa. Intraepithelial injection of cidofovir reduces damage to the laryngeal structures and thus improves vocal parameters. The aim of our study was to compare vocal quality before and after cidofovir and CO2 laser treatment by means of objective phoniatric parameters and to obtain evidence concerning voice outcomes. The vocal parameters of 42 patients with RRP were assessed before and after intralesional cidofovir and CO2 laser debulking treatment (Lumenis AcuPulse 40 CO2 laser, wavelength 10.6 μm; Lumenis Ltd., Yokneam, Israel). The laser was used in SuperPulse™ mode with power tailored on the target structures (average 7 W). The depth of tissue penetration was 1 mm with a single burst of energy lasting 0.3 ms. Most of the patients had previously undergone traditional surgery (1–105 procedures); in 7/42, the video stroboscopic examination revealed extensive scar tissue covering the mucosa of the vocal folds, limiting the mucosal wave. The significance level for all calculations was p

Dysphagia is an underestimated health problem. At the same time, it is a potentially life-threatening condition. Dysphagia in young adults is rare and thus it is rarely discussed in the literature. Vascular anomalies are much less frequent causes of dysphagia than structural pathologies of the digestive system, iatrogenic lesions or neurological causes. This paper presents a case of a 21-year-old woman with escalating dysphagia in the course of a congenital vascular anomaly in the form of a right-sided aortic arch with retroesophageal left subclavian artery (left arteria lusoria) and compression. The paper highlights delayed symptomatology of the congenital defect, reasons behind the long-lasting diagnostic process, and the role of the laryngological – phoniatric examination in order to exclude oral and pharyngeal causes. The differential diagnostics and treatment options are discussed thereinafter.

Phoniatricians usually have the key role when dealing with a voice disorder, supported by logopedists/speech-language pathologists. Cooperation with other medical or non-medical disciplines may contribute when needed. Fundamentals, general goals and the structure of voice therapy are followed by a survey of specific methods and techniques. No matter what kind of technique is used, treatment strategy is inevitably based on pathophysiological mechanisms of a disorder and the patient’s state as a whole. Voice therapy is a dynamic process and not an application procedure for a stable phonatory pattern or a list of exercises for every patient. This integrative model for treatment of voice disorders includes additional skills and knowledge of mechanisms of applications, stages of behavioural treatment, phases of motor learning, stages of voice therapy and steps of a given technique. Functional disorders of the singing voice (dysodia) require additional and specific expertise, especially in emergency situations in the frame of cancellation policy regarding the opera and theatre business. Drug treatment and physiotherapy/osteopathy as more therapeutic approaches to voice disorders are presented, as well as phonosurgical procedures, i.e. functional surgical interventions aiming exclusively, or in part, at improvement, restoration or preservation of vocal function. Methods comprise of phonomicrosurgery (endoscopic microsurgery), laryngeal injection and laryngeal framework surgery that modify the cartilaginous framework of the larynx (laryngoplastic phonosurgery, open-neck surgery). Pacing and reinnervation are also discussed as alternatives in bilateral vocal fold palsies, and vocal rehabilitation after head and neck surgery, including the use of personalised computer speech synthesis for laryngectomised patients, is considered. Indications for tracheostomy and tracheostoma care refer to clinical practice. The prognosis of voice rehabilitation depends on the various factors that are included in voice production and should be considered accordingly.

Basic information for diagnosis and differential diagnosis of voice disorders is drawn from medical history (the nature of the change in the sound of the voice, pitch, extent and loudness of voice, frequently reported hoarseness and its severity, any occurrence of episodes of voice loss, fatigability of voice) and auditory evaluation (mean speaking pitch, voice onset, pitch range, capability of increasing loudness, perceptual scale of the sound of the voice including nasality, stability). Self-administered questionnaires have proven to be important instruments for the evaluation of the impact of a voice problem on the quality of life of patients. Objective data are available from acoustic analyses (phonetography [voice range profile], visible speech [spectrography], quantification of Fo, voicing %, perturbation parameters, harmonics-to-noise ratio, etc.) and from aerodynamic measurements (maximum phonation time, body plethysmography). In addition to the classic assessment of the laryngeal structures by means of laryngoscopy, stroboscopy is a widely used standard as a subjective tool for the visualisation of vocal fold vibration. Among objective approaches, videokymography is increasingly being used, and high-speed video with consecutive vibrogram display and electroglottography are other options. Vibrational analyses are particularly useful for the detection of beginning malignomas and hidden lesions. They may be also helpful for the evaluation of the vibrating lips within the practice of musician’s medicine for assessing the occupational (in)capacity of professional brass musicians. Electromyography (EMG) is indicated for vocal fold immobility of unknown origin to distinguish paralysis from mechanical fixation. Ultrasound sonography may concern spoken articulation as well as phonation. Proposals for voice loading tests, because of the complexity of the issue, need further improvement and standardisation.

The chapter reflects the main clinical manifestations of voice disorders, the wide diversity and multiple sociocultural interrelations of which contrast with a consistent systematic order of aetiological or symptomatic categories. Instead, the compilation follows prevailing purposes to provide a useful overview for application in everyday practice. Functional dysphonias, psychosomatic voice dysfunction and singing voice disorders are closely related to each other but nevertheless require individual consideration regarding special diagnostic procedures as well as therapeutic or rehabilitative consequences, including occupational perspectives. Organic manifestations comprise benign lesions of the mucosa of the vocal folds, gastro-oesophageal reflux influences, central and peripheral neurogenic disorders and laryngeal sensory neuropathy. A section on hormone-related dysphonias is followed by a survey on gender vocology focused on the demands of male-to-female as well as female-to-male adaptation of transsexuals. Voice disorders in systematic diseases and also as consequences of environmental influences and allergy complete the chapter that includes paying attention to special aspects of the voices in childhood and adolescence and the elderly population. Malign lesions are not part of this chapter.

Background. Vertigo as a symptom accompanies many pathological processes leading to damage of the vestibular system at a peripheral or central level. It is a manifestation of systemic diseases. Vertigo is one of the most common causes of presentation of the patient to a general practitioner. One of the most common causes of sudden vertigo is benign paroxysmal positional vertigo (BPPV). Objectives. Assessment of the effectiveness of the canalith repositioning procedure in idiopathic and posttraumatic BPPV. Material and methods. 50 people with BPPV aged 22–78 (mean 53 ± 13), divided into 2 groups of 25 subjects each, suffering from posttraumatic (group A, aged 53 ± 15) and idiopathic (group B, aged 53 ± 11) vertigo. The treatment was conducted using the Epley manoeuver, controlling its effectiveness by means of the Dix-Hallpike manoeuvre. Results . All the treated patients benefited from the therapy. The percentage of patients cured after the first two medical manoeuvres was 52% (13) and 92% (23) in groups A and B, respectively, which is a statistically significant difference (p = 0.0016). Patients in group B had an 18 times higher chance of regression of symptoms as early as after the first medical manoeuvre. The number of performed manoeuvres which guaranteed full effectiveness was on average 1.16 per patient with only one semicircular canal affected, and 3.5 when semicircular canals on both sides were affected. Conclusions . 1. The application of motor rehabilitation in the course of BPPV is a non-invasive method for treating vertigo with high effectiveness. 2. Trauma in medical history prolongs the treatment of BPPV using manoeuvre. 3. If BPPV affects both sides, the manoeuvre should be repeated more times. 4. The characteristic medical history and risk factors (trauma) facilitate forming a suspicion of the diagnosis with a high probability as early as in the office of a general practitioner.

Mechanical debulking of laryngeal papillomas is associated with voice disorders due to impairment of the vocal fold's mucosa. Intraepithelial injection of cidofovir reduces damage to the laryngeal structures and thus improves vocal parameters. The aim of our study was to compare vocal quality before and after cidofovir and CO

BACKGROUND Numerous studies have discussed cases of concomitant temporomandibular disorders (TMD) and otologic symptoms (OS). However, attempts to determine the true origin of these symptoms combined with assessments of the condition of the organ of hearing are relatively rare. This study aimed to evaluate the frequency and type of OS in patients with TMD, and attempted to determine the origin of the OS in the studied group of patients. MATERIAL AND METHODS 246 patients, aged 40.08±11.12 years (F=147, M=99) with TMD, from the Department of Oral Rehabilitation of Poznan University of Medical Sciences. METHODS dental history interviews and clinical examinations. There were 2 groups-G1 and G2-selected on the basis of the presence or absence of OS in the medical history stage. After audiological evaluation, 2 subgroups were identified: G1.1 and G1.2. RESULTS OS were observed in 36.18% (G1). In 48 patients (53.93%), the audiological evaluation found there was no impairment of the organ of hearing (G1.2). Audiological abnormalities were found in 46.07% (n=41) of the patients (G1.1). The OS which differentiated the 2 groups were a plugging sensation as well as otalgia (more frequent in group G1.2) and hearing impairment (more frequent in group G1.1). CONCLUSIONS 1. The OS which most frequently accompany with TMD were fullness and otalgia. 2. It is recommended that a subjective assessment of hearing loss in patients with TMD and concomitant OS should be included in the medical history stage. 3. Clicking and popping are significantly more frequent in patients without concomitant hearing impairment.

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/, /c/, /dz/ sounds (sigmatismus interdentalis). Hearing loss was confirmed.

Cochlear implants programme in Poznan started in 1994 and till now consists of over 1020 systems (including 29 hybrid ones). Bilateral implantations were done in 25 patients, including 5 simultaneous and 20 sequential implantations. Simultaneous implantations were performed in 3 cases with radiological symptoms of cochlea fibrosis/ossification (meningitis, temporal bone trauma) and in 2 cases due to vision loss in Usher syndrome. Sequential implantations were performed in 3 adults (in 2 due to intensive tinnitus, in 1 to improve sound localisation) and in 17 children (in 1 due to vision loss, in 2 due to skin flap problems and in 14 to improve sound localisation and speech discrimination in noise). The time interval between surgeries in the group of 14 children was 1 year 7 months till 12 years 4 months (average 3 years 10 months). All the children in this group use both devices for all the time – from the speech processor switch-on they used second device for the whole day. More observations and rehabilitation results are required to acquire experience from bilateral implantations in small children in the developmental age.

Background. Objective electrophysiological methods for investigations of the organ of smell consist in recordings of olfactory cortex responses to specific, time restricted odor stimuli. In hypothyroidism have impaired sense of smell.Material and Methods. Two groups: control of 31 healthy subjects and study group of 21 with hypothyroidism. The inclusion criterion for the study group was the TSH range from 3.54 to 110 μIU/mL.Aim. Assessment of the latency time of evoked responses from the olfactory nerve N1 and the trigeminal nerve N5 using two smells of mint and anise in hypothyroidism.Results. The smell perception in subjective olfactory tests was normal in 85% of the hypothyroid group. Differences were noticed in the objective tests. The detailed intergroup analysis of latency times of recorded cortical responsesPN5andPN1performed by means between the groups of patients with overt clinical hypothyroidism versus subclinical hypothyroidism demonstrated a significant difference (p<0.05) whereas no such differences were found between the control group versus subclinical hypothyroidism group (p>0.05).Conclusion. We can conclude that registration of cortex potentials at irritation of olfactory and trigeminal nerves offers possibilities for using this method as an objective indicator of hypothyroidism severity and prognostic process factor.

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.

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.

Summary Disorders of communication process concerns voice, speech and hearing problems. The most common voice disorder in ENT practice is dysphonia. Mostly it is acute inflammation, but also functional dysphonia in which an abnormal voice is produced in the absence of vocal pathologies, either structural or neurogenic. It could be also vocal folds paralysis dysphonia or voice disorders due to benign organic vocal fold lesions. Some of those organic changes (vocal nodules, polyps, hypertrophy and thickening of vocal folds epithelium) frequently appears in cases with vocal abuse or inappropriate vocal use. Children's speech development closely depends on hearing, intelligence average, central nervous system function as well as on articulation organ morphology. Hearing problems as a etiological factor of communication process disorders in ENT practice, supposed to focus on early detection and management of hypacusis in newborns (screening stages) as well as on a proper diagnosis and treatment of conductive hearing loss or unilateral deafness.

Summary In this review authors presented up to date indications for implantable hearing aids. This consensus was elaborated by a team of outstanding polish surgeons and audiologists and was accepted by the board of the Polish Otolaryngologist Society. In this article the indications audiology diagnostic, surgical issues and postoperative management are presented.

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. Patient's 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.

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 percep...

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.

Background Chronic undernourishment in the course of anorexia nervosa leads to various metabolic and hormonal changes, which translates to the impaired functioning of the majority of systems and internal organs. The impact of eating disorders on the condition of the vocal apparatus has been described in the literature; nevertheless, it concerns mainly bulimia nervosa. Objectives assessment of the vocal apparatus in adolescent girls diagnosed with anorexia nervosa from the point of view of possible influence on the function and structure of the larynx, low body mass accompanying anorexia, as well as energy deficiency, hormonal and emotional disturbances. Materials and methods The research included 41 girls aged 12–19 years, diagnosed with anorexia, who were assessed for the condition of the vocal apparatus, using the perceptual assessment of voice according to GRBAS scale, videolarynostroboscopy, acoustic assessment, and voice self-assessment in Jacobson's VHI scale (voice handicap index). Results The perceptual assessment of voice using the GRBAS scale revealed that changes in voice were mainly weak, asthenic in nature (70.73%) and there was also the feature of puffing perceived in voice (41.46%). In voice self-assessment with the use of VHI, most subjects seemed to point to changes of voice self-perception in emotional subscale (68%). Videolaryngostroboscopy revealed some features of functional disturbances of voice in more than half of subjects, mainly in the form of hyperfunctional dysphonia (31.78%). The maximal phonation time was significantly shorter, in proportion to duration of the primary disease. In the acoustic analysis, the decrease in the basic frequency F0 and narrowing of the voice scale were observed. 55% of older, post-adolescent patients presented with the structure of the larynx that was inappropriate for their age. Conclusions These results might indicate that anorexia nervosa could have led to the structural and functional changes in the vocal apparatus. Such disturbances may be explained by the hormonal dysfunctions as well as starvation. Hormonal substitution at the appropriate time might be beneficial for the structure and phonation function of the larynx in girls with AN.

Objective Multicenter evaluation of the quality of life and quality of hearing after Nucleus® cochlear implant placement in patients over 60 years of age. Reference and method Evaluation was performed in patients receiving cochlear implants after the age of 60 years as a part of the Cochlear-Implanted Recipient Observational Study (Cochlear-IROS). This study is a prospective, international and long-term assessment which enables observation of recipients for up to three years after implantation. Data regarding subjective evaluation of the quality of life and quality of hearing were gathered before the first switch-on of the sound processor and one year afterwards. Standardized questionnaires were used in this evaluation, including Health Utility Index (HUI mk. III) and Speech, Spatial and Qualities of Hearing (SSQ) Scale. Data were also gathered regarding the aetiology of hearing loss, hearing aid usage, tinnitus and vertigo, as well as on the telephone usage and the professional status of recipients. Results Included in the evaluation, were 20 subjects who were over 60 years old at the moment of the cochlear implant surgery. The study group consisted of 12 men and 8 female patients. The average age of CI recipients at the moment of implantation was 67.8 years (min. 60, max. 80 years). The SSQ questionnaire outcomes regarding self-assessment in the field of ability to hear in everyday situations one year after the surgery indicate that speech understanding increased by 180%, spatial hearing increased by 135 % and quality of hearing increased by 98%. Overall quality of life before the first sound processor switch-on as assessed using the HUI questionnaire was at the level of 0.38 (on 0-1 scale, where 0 equals death, and 1 equals full health). One year after the implantation, this assessment increased by 33% (up to 0.5 on the scale). Conclusion The effectiveness of the cochlear implantation in patients with severe hearing loss after 60 years of age with respect to the quality of life and hearing was confirmed. Statistically significant improvement was demonstrated in the self-assessment of patients in relation to the speech understanding, spatial hearing and quality of hearing, as well as quality of life.

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.

Objectives: It has been suggested that dyslexia is linked to a core cognitive deficit in phonological awareness tasks and/or in the processing of auditory stimuli. Auditory evoked potentials are a valid, objective measure of the accuracy of central auditory processing in humans. The aim of this study was to assess auditory evoked potentials in children with dyslexia. Patients and Methods: Sixty-six children participated in the study. A set of hearing tests and the recording of complex event-related potentials (ERPs) were performed. Results: Mixmatch negativity (MMN) and P300 waves were significantly more frequent in the healthy children (control group) than in children with dyslexia. The P300 wave was present in all subjects from the control group, the MMN wave in 92% of them. In the dyslexic group, complex ERPs were recorded roughly 33% of the time. Latencies of complex ERPs in children with dyslexia were greater than latencies in children in the control group. MMN and P300 maturation (change with age) was observed only for the control group. A wide range of MMN and P300 responses was observed across children with dyslexia. Conclusion: Complex ERPs may be useful in determining the condition of audiologic functions; however, on their own they are not sufficient to recognize dyslexia because of the heterogeneity of nonspecific changes.

Background Treatment of laryngeal cancers, may include surgery, radiotherapy, chemotherapy, or a combination. Total laryngectomy (TL) has been the standard surgical treatment. Partial laryngectomy procedures were performed, their advantage over TL is preservation of laryngeal functions. Methods The investigation was carried out on a group of 20 patients (3 female and 17 male), who underwent surgery according the techniques mentioned above. The methods of investigation were based on perceptual voice estimation (GRBAS), videolaryngostroboscopy, acoustic voice analysis, aerodynamic measure maximum phonation time, voice self-assessment (VHI). Results and Conclusions The perceptual voice estimation revealed a good phonation result in only 3 cases after using surgery with the Calearo method as well as the best results of MPT. The VHI reflected severe voice handicap in 2 patients (26 to 40 points). No statistically significant differences were observed between the values of the acoustic parameters in MDVP analysis after following operation -CHEP, Calearo, Sedlacek.

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.Presentation of the results of the physiotherapy and voice rehabilitation treatment established for patient with voice disorders, occurred after cranio-cerebral trauma.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 rehabilitationAfter four months of treatment and after self-therapy exercises the significant changes were observed. Patient's voice became no more strain, but stronger and socially effective.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 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.

Objectives: As shown in our previous paper, the dimensions of the cerebral parts of the cranium and face of the vocal students were higher than those of the non-singing students. The aim of the present study was to analyse the type of voice and its development depending on selected dimensions.Methods: A total of 56 vocal students – 36 women and 20 men – who underwent anthropometric measurements were divided into groups according to their voice type. Two professors of singing made a subjective, independent evaluation of individual students’ vocal development progress during the four years of training. The findings were analysed statistically with the current licensed versions of Statistica software.Results: We found statistically significant positive correlation between: the head length, head and face width, depth of upper and middle face, nose length and student’s voice development.Conclusions: The dimensions of the head and the face have no impact on type of voice; however, some anatomical charac...