Assessment of short-term functional voice therapy in patients with unilateral paralysis of the larynx.

Introduction Laryngeal paralysis deteriorates all laryngeal functions. Therefore the therapeutic process must include restoration of respiratory, defensive and vocal function. Selection of a proper rehabilitation path plays a key role. Appropriate research protocol that includes objective methods of voice evaluation is an important element of monitoring the return of vocal efficiency. Voice efficiency is important for the patient particularly due to psychological and social reasons. Aim The aim of the study was the assessment of short-term functional voice therapy (FVT) in patients with unilateral paralysis of the larynx with the usage of objective parameters describing the glottis and voice quality. Material and Method During the last 10 years 355 patients with laryngeal paralysis were hospitalized in the Audiology and Phoniatrics Clinic due to dysphonia. All patients undergone 5-day FVT. From 2015 we unified diagnostic protocol measuring parameters obtained from videostrobokymography (VSK), electroglottography (EGG), perceptual and acoustic voice analysis before and after 5 day hospitalization. Results After FVT patients improved voice quality and glottal compensation. The majority of patients achieved a statistically significant improvement in the VSK, EGG, MDVP and perceptual analysis. Group of patients with unsatisfactory voice improvement after therapy required a prolonged rehabilitation or has been qualified for laryngeal microsurgery. Potential factors that could have cause insufficient effects of FVT were analysed. Conclusions The complexity of voice rehabilitation is crucial for the success of therapy. Interdisciplinary therapeutic team plays a significant role during voice rehabilitation in patients with vocal fold paralysis.

Immediate speech fluency improvement after application of the Digital Speech Aid in stuttering patients.

BACKGROUND: The Digital Speech Aid (DSA) is a pocket-sized device used for speech correction in stutterers. The device modifies the patient's auditory feedback with the use of Delayed Auditory Feedback (DAF) and Frequency-shifted Auditory Feedback (FAF). Both methods are well-known to improve speech fluency in stuttering persons. The aim of this study was to assess immediate disfluency reduction after application of the DSA. MATERIAL/METHODS: The study included 335 patients aged 6-64 years with speech disfluency. DSA fitting was performed during 3-day hospitalization. Speech disfluency was assessed during reading, in dialogue and in monologue before fitting and after selection of optimal DAF and FAF parameters. Fluency improvement was assessed statistically with Student's t test for logarithms of the odds of disfluency presence without the DSA and with the DSA. RESULTS: For all speaking situations, statistically significant improvement was achieved, with p<0.005. Immediate fluency improvement was observed in 82.1% of patients during reading, in 84.5% during dialogue, and in 81.2% during monologue. Values different from placebo (reliable improvement) were obtained in 66.9% of patients during reading, in 66.6% during dialogue, and in 63.9% during monologue. CONCLUSIONS: The results show that the DSA is an effective tool for immediate disfluency reduction in stutterers.

Stuttering patients' opinions on the Digital Speech Aid.

BACKGROUND: The Digital Speech Aid (DSA) is a portable device used to reduce stuttering. It incorporates delayed auditory feedback (DAF) and frequency-shifted auditory feedback (FAF). Due to its small size, the DSA can be used by the stutterer in everyday life. MATERIAL/METHOD: Three hundred thirty-five stutterers aged 6-64 years were included in the study. A subgroup of 100 stutterers who had used the device for at least six months was asked to fill out a questionnaire of 25 questions about their opinion of the device. The data were analyzed and the factors determining the patients' satisfaction with the device were investigated. RESULTS: The analysis showed that the patients used the DSA regularly for about 3 hours daily. Most patients applied the device at home; only small number used it at work or at school. Most patients (70%) reported decreased fear of speaking and improved self-confidence during communication when using the device (78%). Eighty-eight percent of the patients described the device as very useful or useful in everyday life. That patients' satisfaction with the device was not related to objective speech improvement but to a subjective feeling of increased self-confidence and decreased fear of speaking. CONCLUSIONS: The DSA is positively judged by patients as an option in stuttering therapy. Its effect can be attributed not only to fluency improvement, but also to increased self-confidence and reduced fear of speaking.

[Plan of therapy and rehabilitation in stuttering patients]. / Schemat postepowania terapeutyczno-rehabilitacyjnego u osób jakajacych sie.

The aim of the paper is to present the program of therapy and rehabilitation in stuttering patients based of the digital speech aid. The device has been applied to 130 patients aged 6-47 y.o. 85% of the patients had statistically significant instant improvement of speech fluency after application of digital speech aid. After completing diagnostic process, the patients were enrolled for the rehabilitation program which comprised of training with the use of speech aid, speech therapy, psychotherapy, audio-psycho-linguistic stimulation with the use of the Tomatis Method, physiotherapy, relaxation exercises, phoniatric rehabilitation and medical therapy. After 6 months of therapy and rehabilitation a statistically significant improvement of speech fluency was found in 124 patients, i.e. in 96%. The therapeutic programme based on the use of digital speech aid proves effective for majority of stuttering patients.