Biomedical subjects
Publications and source records attributed to A Pruszewicz.
A device for objective assessment of hypernasality index (percent rate of nasal acoustic energy to the whole energy produced during phonation or speech) of own construction is presented. The possibilities of clinical aplicability are discussed.
The material of this investigation comprised a group of 18 patients with deep hypoacousis (over 70 dB) or complete deafness which, depending on the onset of the deafness, was divided into the 3 categories: congenital, early childhood to 3rd year of life, and postlingual. All of them underwent ENT, phoniatric and stroboscopy examinations; in 10, X-ray tomography of the larynx was also performed. The status of hearing ability was assessed by audiometric examinations using pure tones in air and bone conductions. The acoustic examinations comprising spectrographic and tonographic analyses were performed on an appropriate linguistic material including vowels, isolated words, sentences and reading text. The measurement of Fo was performed on isolated vowels. In order to characterise the degree and kind of periodicity disturbances the following parameters were estimated: the medium value of fundamental frequency, the range of Fo variability, the maximal change of period length from cycle to cycle, and its medium value (jitter). The results of the acoustic examinations revealed different degrees and kinds of periodicity disturbances depending on the depth of the hypoacousis and its onset.
Subject for the examination were 30 patients who during total laryngectomy had had two silver clips for haemostasis inserted into the cricopharyngeous muscle about 3 cm from the sewing place in the midline, facilitating the location of the muscle and the placing of a needle electrode. Twelve to 18 months after laryngectomy and phoniatric rehabilitation, electromyographic examinations were performed. Each EMG recording was evaluated as to amplitude, discharge frequency and time duration of muscle electric activity. EMG recordings made during deglutition and phonation proved dependences of cricopharyngeous muscle activity on quality of oesophageal voice production and higher activity of muscle during phonation than deglutition in patients who developed very good and good oesophageal speech.
The study was on subject of preservation of directional hearing in free auditory field, in horizontal plane in different stages of pathological lesions of the bearing organ with properly fits hearing aid from Viennatone as the behind-the-ear hearing aid (model 116 PAD) and the hearing spectacles (model 90 AN). There were noticed in 50 percentage of subjects improvement in the directional hearing. The best results was obtained in unilateral deafness. The evidently amelioration was observed in front azimuths. The obtained improvement directional hearing was not proportional to the stage of hearing improvement.
Phoniatric and acoustic examinations were carried out in a group of 30 patients with dysphonia, including 15 with organic type and 15 with functional type. A complex phoniatric assessment offered the possibility to differentiate between these two groups of pathological voices. This was achieved also on the basis of acoustic analysis of the voice by extracting characteristics such as: formant frequency, Fo and its range, percentage of noise in the analysed verbal text, mean and maximum values of jitter. The possibility of differential diagnosis of these two different types of dysphonia in acoustic studies was confirmed by clinical examinations. The acoustic studies presented can be regarded as a new approach to a fast and sufficiently precise method in the screening diagnostics of dysphonia conditioned by growth of the vocal fold mass.
Based on the experience of the Olfactogustometry Laboratories in Halle and in Poznan, a proposal of clinical terminology and systematization of smell and taste disorders has been presented. Individual interpretation of the data from anamnesis in relation to the findings of the olfactogustometric investigations were stressed as indispensable.
In 27 patients with cleft palate and pseudoprogeny the osteotomy according to Le Fort I and in 7 patients the accessory oblique osteotomy were performed. The phoniatric evaluations as well as the palatal and linguographic examinations proved the amelioration of the articulation in the second zone. The dental occlusions were also better as well as the speech intelligibility.
The median of simple motor reaction (RT) to a flash parallels the latencies of visually evoked potential (VEP) deflections if flash intensity is varied. However, mean and median reaction times are not equal because of the skewness of RT distribution. It therefore seemed plausible that the mean reaction time--intensity relationship would be steeper than that for VEP latency. Such divergence would account for the intensity-dependent motor component of RT revealed by other psychophysical studies. The latencies of VEP deflections were measured as a function of intensity and the results were compared with mean and median RTs. The difference between mean and median RT is constant and independent of flash intensity. Moreover, both values are parallel to VEP latency. The general pattern of results remains the same after a change in the distribution from which the foreperiod is sampled.
An analysis of the results of electrophysiologic examinations of hearing (impedance audiometry, BSER, MLR, SP) in 50 patients aged between 1 and 9 years perceptive bilateral hypoacusis reveals that the system of objective methods makes it possible not only the differentiation of cochlear and retrocochlear lesions, but also to demonstrate changes in upper part of the hearing tract. Electrophysiologic examinations of hearing help us to reveal the causes of failure in rehabilitation of speech and hearing and make possible to objectively study the conditions of hearing. In can be assumed that in the future combination of electrophysiologic methods with modern ways of imaging, changes in the nervous system will allow us to interpret by topographic diagnosis the results of EA examinations more deeply.
The experiences with the plastic surgery of pharyngo-oesophageal sphincter during the laryngectomy were presented. The sphincteric forces were studied accordingly to the rehabilitation successes and also the acoustic and perceptive data of the oesophageal speech. The results were compared with these after the classical laryngestomy. It was pointed out that the sphincteroplasty lowered its tension and made the rehabilitation more easier. The oesophageal voice produced in this occasion is better than after the classical laryngectomy. The fundamental frequency is two times higher, the prosody and speech tempo more normal. These positive results were encountered in 76% of cases. However, in some cases the psychological and social difficulties were so great that we preferred the surgical rehabilitation with shunt formation.
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