Voice disorders among players of wind instruments?
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Biomedical subjects
Publications and source records attributed to W Pascher.
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Literature on functional voice disorders, on their etiopathogenetic criteria linked in a complex way, on the multifaceted aspects of the symptoms, and on the varieties, which arise out of influences during the long-term course of the disease has reached a considerable volume. In relation to this fact, the description of therapeutic methods is thin and there is only sparse attention given to quantitative facts, such as intensity and duration of therapy and the possible influences of patients' professional field on the therapeutic course. However, there is general agreement that qualitative features and quantitative volume of therapy should be enlarged under the holistic aspect of an adequate therapy of voice function, depending on individual necessities. Under such a holistic aspect, two fundamental ways of therapy are possible and both ways have advantages and disadvantages, which originate from principal differences: out-patient therapy and in-patient therapy. The Hamburg-Concepts of out-patient therapy of professional voice disorders which were created, tested, corrected and in a long-lasting process finally structured in terms of operational diagrams are discussed in this paper under different points of view: the precondition is a complete evaluation of all influencing factors in an interdisciplinary process. In closing, a new program of cooperation between the institution for in-patient voice therapy in Werscherberg/Osnabrück and the Hamburg Team is mentioned, a program which, though very complex and risky, is intended to close the gap between in-patient and out-patient therapy.
A comprehensive rehabilitation program for laryngectomized patients is presented, consisting of close cooperation between the ENT clinic, phoniatric department and post-operative reconvalescent institution. Four main points are emphasized: (1) rehabilitation with both the oesophageal voice and the vibrator voice; (2) involvement of the patient's partner in the whole rehabilitation program, including participation in the 4-week stay in a post-operative reconvalescent institution; (3) information for the employer about the special needs of a laryngectomee; (4) contact with the regional branch of the laryngectomees' association.
We report 14 patients who took part in a specially designed comprehensive rehabilitation programme for the laryngectomee. Our results clearly indicate that it is only possible to carry out such a project successfully if there is intensive communication between all participants in the programme, including the patient and his/her partner.
A prospective study of vocal function was undertaken before and after CO2-laser surgery for benign tumors and lesions of the larynx: 50 patients with polyps, Reinke's oedema's, leukoplakia etc. were investigated and controlled phoniatrically, including indirect microlaryngoscopy and microstroboscopy. 3 investigators rated the results independently. Laser surgery can minimise tissue damage, as demonstrated by good restoration of vocal function.
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A law for studying logopedics was established by the authorities of the Federal Republic of Germany. On account of a political concept of education the conditions for admittance studying logopedics are based on an extremely low level. Reasons for rejecting these admitting conditions are displayed from a phoniatrical view.
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In the fourth part of a series on applied phoniatrics, a review of vocal disorders as symptoms of neurological and psychiatric diseases is given. Clinical characteristics, diagnosis, as well as laryngologic and phoniatric aspects of therapy of vocal cord paralysis are also described.
In the last of 5 articles on the benefits of applied phoniatrics hints are given on the differentiation between laryngeal inflammations and tumours. Voice rehabiliation after laryngeal surgery (laryngofissure, partial laryngectomy, total laryngetomy) is demonstrated. Disorders of voice caused by intubation are also described.
Definition and classification of functional dysphonies are problematic. Division into phonoponosis and phononeurosis is used. The terms hyperkinetic and hypokinetic dysphonia are replaced by definitions of hyperfunctional and hypofunctional dysphonia which are better applicable in clinical work. Etiology and symptoms of functional dysphonies and some pragmatically important aspects of therapy are described.
A survey of possibilities and methods for examining voices in otorhinolaryngologic practise is given as an introduction to a series of articles on applied phoniatrics. In the present review, an attempt is made to demonstrate a pragmatic view of diagnosis and therapy for phoniatric disorders. The voice as the carrier of human speech is considered to be an expression of the total personaltiy so that the phoniatric investigation cannot be resitrcted to disturbed laryngeal function alone. All aspects of the voice as it relates to the individual and his surroundings are included within the diagnostic evaluation.
Juvenile and hormonal dysphonias are classified according to organic and functional etiologies. The clinical characteristics of each are described by emphasizing differential diagnostic and therapeutic aspects.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.