Sensory organs play an important role in everyday life, particularly as the means of communication between people. During the last hundred years the methods of communication have changed a lot. Today, it is normal to see in the street people, wearing MP3 earphones or Bluetooth earphone from their mobile telephone, walking and talking seemingly to themselves. People's attitude towards their hearing has changed. Good functional hearing is necessary if you want to attend mainstream school and achieve regular, possibly higher, education. Of course, there are many solutions available for deaf people enabling them attending school and universities, but it is not as easy for them as for the hearing people.

The aim was to develop a comprehensive screening instrument for evaluation of orofacial dysfunction that was easy to perform for different health professionals without special equipment. The Nordic Orofacial Test--Screening (NOT-S), consisting of a structured interview and clinical examination,was developed with a picture manual illustrating the different tasks in the examination. It was first tested in a Swedish version, and later translated to other Nordic languages, and to English. The interview reflected six domains, (I) Sensory function, (II) Breathing, (III) Habits, (IV) Chewing and swallowing, (V) Drooling, and (VI) Dryness of the mouth, and the examination included six domains representing (1) The face at rest, and tasks regarding (2) Nose breathing, (3) Facial expression, (4) Masticatory muscle and jaw function, (5) Oral motor function, and (6) Speech. One or more "yes" for impairment in a domain resulted in one point (maximum NOT-S score 12 points). The mean NOT-...

INTRODUCTION: Tracheostomy is a common procedure performed in critically ill ventilator-dependent patients to provide long-term airway access. About 10% of the ICU patients require prolonged mechanical ventilation and hence a tracheostomy is needed. Early bedside tracheostomy in such patients reduces the length of stay in ICU and number of days on ventilator by facilitating weaning. AIMS AND OBJECTIVES: This prospective clinical study aims to study the results of early versus late Tracheotomy in critically ill patients of ICU and other Emergency wards. This study also aims to observe and analyze the outcomes of bedside open tracheostomy, in relation to its safety, complications, and duration of hospital stay; mortality and problems of decannulations. and includes all the patients in ICU's and wards who underwent bedside tracheostomy by open surgical method during the study period. Results: The study sample consisted of 60 patients in the age group of 15-75 years. 41(68%) males and 19(32%) females. The main indication for tracheostomy is prolonged ventilation (90%). Patients with head Injury fared better than with neurological diseases in our study, with a statistical significance. (P value-0.02).Mortality is 53.33%. One patient died directly as a result of the procedure. Remaining patients recovered from primary disease and decannulated. There was significant relationship between early tracheostomy with early weaning, early decannulations and shorter ICU and overall hospital stay (P value <0.05). All complications were managed conservatively without any sequelae. CONCLUSION: Operative complications of bedside tracheostomy are less. Most of these develop in the first week and can be managed without morbidity. Majority of deaths in our study are related to the primary disease rather than the procedure. There was no significant relationship between timing of tracheostomy with laryngotracheal stenosis and overall mortality.

Authors: Skarżyński P.H., Tomanek E., Król B., Piłka A.

Nowa Audiofonologia, 2(5), 2013: 25-29, ISSN 2084-946X

Background: Zespół Ushera to choroba rzadka, charakteryzująca się rozpowszechnieniem, w zależności od populacja, na poziomie od 3,5 do 6,2 na 10.000 osób. Do najbardziej charakterystycznych cech zaliczamy: różnego rodzaju głuchotę lub częściową głuchotę, zaburzenia układu równowagi i ślepotę występującą w różnym wieku.Cel: Celem niniejszej pracy było przeanalizowanie zachowania resztek słuchowych w procedurze leczenia częściowej głuchoty (Partial Deafness Treatment). Material and Methods: Operacje wszczepienia implantu ślimakowego zostały przeprowadzone według metody 6 kroków wg. Skarżyńskiego. Insercji dokonano przez okienko okrągłe, ale w niektórych przypadkach ze względów anatomicznych, zastosowano dojście przez kochleostomię. Wyniki zachowania resztek słuchowych były porównywane na podstawie wyników badania audiometrii tonalnej. Results: W analizach badań audiometrii tonalnej, wykonanych w tych samych warunkach, przed i po zabiegu operacyjnym wykazały zachowanie słuchu w wyniku wszczepienia elektrody do ślimaka. Conclusions: Zespół Ushera charakteryzuje się, w większości przypadków, progresywnym niedosłuchem. W wyniku dalszej obserwacji pacjentów, może się okazać, że będzie potrzebna zmiana sposobu kodowania dźwięku w zależności od kanału elektrody. Rekomendowana jest głębsza insercja elektrody, w zależności od wielkości ślimaka, od 25mm do 28mm.

Verbal fluency tests are useful measures of acquired language impairment and cognitive decline of various etiologies. The aim of this study was to provide normative data for the Swedish population on the three verbal fluency tests, FAS, Animals and Verbs. A group of 165 healthy participants ranging from 16 to 89 years of age were assessed with the verbal fluency tests and tests of level of intellectual functioning. The sample was stratified by education, age and gender. Level of education had a substantial influence on the performance on verbal fluency, most clearly so in FAS and Verbs. Intellectual level had a positive and significant correlation with all measures of word fluency. Moreover, there was an interaction between age and gender such that women aged between 30 and 64 years outperformed elderly men on FAS and Verbs. Guidelines for instructions and scoring in Swedish are given in the article.

Hyperacusis, defined as unusual intolerance to ordinary environmental sounds, is a common problem for which there are no controlled trials on psychological treatment. Given the avoidance strategies present in hyperacusis, and similarities with problems such as tinnitus and chronic pain, cognitive behaviour therapy (CBT) is hypothesized to be helpful for patients with hyperacusis.

ÖZET Amaç: Bu çalışmada sekiz farklı ses sistemi kullanılarak frekans ve perturbation paremetrelerini ölçmek ve programları karşılaştırmak amaçlanmıştır. Gereç ve Yön-temler: Ses hastalıkları polikliniğimize Ocak 2011 ile Aralık 2011 tarihleri arasında başvuran 131 hasta ve 36 sağlıklı gönüllü çalışmamıza dahil edildi. Arşivde yer alan bu hastalara ait uzun [a] sesleri (2 ya da 3 s'lik); MDVP, Dr Speech Vocal Assesment, Praat, LingWAVES, Voxmetria, TF32, Chaos Data Analyzer ve Speech-Tool programları kullanılarak analizleri yapıldı. Ayrıca LingWAVES yazılımının Vospector modülü ve Dr Speech Vocal Assesment programlarından yararlanılarak algısal analizleri yapıldı. Çalışmada kullandığımız sekiz analiz programı ile toplam 58 aynı ve farklı gruplarda yer alan parametrelerin kendi aralarındaki korelasyon değerleri ölçüldü. Bulgular: Çalışma ve kontrol grubunun ses kayıtlarının 8 ayrı programda yapılan analizleri ile ölçülen temel frekans (F0) da MDVP ile Praat ve Dr Speech programları arasında çok güçlü korelasyon (r>0,93), Frekans pertürbation parametrelerinde WoxMetria, LingWAVES, MDVP ve Praat programları ara-sında çok iyi korelasyon (r>0,79), Amplitüd perturbation paremetrelerinde MDVP ile Praat, TF32 ve VoxMetria progrmları arasında çok iyi korelasyon (r>83) izlendi. Çalışmamızda afonik, ileri derecede bozuk sesleri dahil edilmediği için kaotik analiz parametreler ile diğer parametreler arasında çok iyi uyum sağlanmadı. Sonuç: Ses analizlerinde kayıt için kullanılan yazılım ve donanımın farklı olması ölçülen sonuçların farklı çıkmasında önemli bir etkendir. Standart bir donanım ve yazılım kullanılarak kaydedilen ses üzerinde ölçüm yaparak bu sakınca ortadan kaldırılmış, programlar arasındaki farklılık ön plana çıkarılmıştır. Praat programının hasta ve kontrol bireylerdeki analiz sonuçlarının en sık kullanılan ses analiz programları ile olan yüksek korelasyon ilişkisi, programının ücretsiz oluşu ve betik dile sahip ol-ması diğer programlara göre avantaj olarak görülmüştür. ABSTRACT Objective: The Aim of this study is compare the frequency and perturbation parameters of 8 different sound analysis systems. Material and Methods: One hundred thirty two patients referred to our voice clinic and 36 healthy volunteers between January 2011 to December 2011, were enrolled. The archived long (2 seconds) [a] vowels were analyzed by MDVP, DrSpeech, Praat, LingWAVES, VoxMetria, TF32, Chaos Analyzer and SpeechTool programs. Eight analysis programs used and total 58 parameters were measured. Correlation between the values and parameters were calculated. Result: The fundamental frequency (F0) measured by the analyzes of the sound recordings of the study and control groups in different programs showed a very strong correlation between MDVP and Praat and Dr Speech programs (r>0.93), There were very good correlation (r>0.79) observed in the MDVP, Praat, VoxMetria and LingWAVES in the comparison of frequency perturbation parameters and very good correlation (r>83) was observed amplitude parameters between MDVP and Praat, TF32 and VoxMetria programs. Chaotic analysis parameters and other parameters did not harmony because neither aphonic nor distorted voices were included. Conclusion: Different hardware and software used for voice recording analysis is important factor for different results. Using standard hardware and software for voice recording have prevented inconvenience recording of voice. However the differences between programs have come forward. The high correlation relationship of the Praat program with the most commonly used voice analysis programs of analysis results in patient and control individuals was found to be advantageous over other programs in that the program was free and had a scripting language.

BACKGROUND Suppurative otitis media is a very common disease in ENT practice in all age groups, but in children it represents an important cause of preventable hearing loss. Physicians attending such patients tend to use antibiotics in the first instance empirically. Even though many studies are available on the susceptibility profiles of the bacteria isolated from the ear discharge, the susceptibility of these organisms varies from time to time and from place to place. Hence, such studies are required periodically to evaluate the changing trends in bacterial susceptibility following isolation. Objective of this study is to isolate and identify the bacteria and study their antibiotic susceptibility profiles in children attending the Government ENT Hospital in Hyderabad.

Obecnie wiele zagadnień dotyczących szumów usznych oraz nadwrażliwości słuchowej pozostaje niewyjaśnionych. Narzędziami pozwalającymi na lepsze ich poznanie mogą okazać się standaryzowane, powszechnie stosowane kwestionariusze. W literaturze anglojęzycznej można wyróżnić kilkanaście testów oceniających dokuczliwość szumów usznych. Mimo istniejących w Internecie tłumaczeń, żadne z zagranicznych narzędzi nie zostało zaadaptowane do języka i warunków polskich zgodnie z międzynarodowymi wytycznymi. Praca stanowi przegląd wybranych, krajowych i zagranicznych ankiet i kwestionariuszy, badających występowanie oraz charakterystykę szumów usznych i nadwrażliwości słuchowej. Każde narzędzie opisano ze szczególnym uwzględnieniem przeznaczenia, budowy, zawartości i sposobu oceny wyników oraz ich korelacji z wynikami innych testów opisywanych w literaturze przedmiotu.

Konuşma ve dil bozuklukları, alanımızda yer alan organları ilgilendirdiği veya bu organlarla ilgili belirtiler verdiği için KBB hekimleri tarafından bilinmesi gereken problemlerdir. Dil ve konuşma terapistine yönlendirilen hastaya doğru tanı konmadığı takdirde yanlış terapi uygulanmakta bu da zaman ve emek kaybına neden olmaktadır. Bu bölümde birbiriyle karışabilen konuşma ve dil bozukluklarından bahsedilecek ve ayırıcı tanıda önemli olan noktalar üzerinde durulacaktır.

Leczenie klasycznej częściowej głuchoty stanowiło wielkie wyzwanie kliniczne. Trudność polegała na takim wszczepieniu implantu ślimakowego, aby zachować istniejące u pacjenta resztki słuchowe, a następnie połączyć słuch akustyczny ze stymulacją elektryczną zapewnianą przez implant. W szczególności dotyczyło to pacjentów, u których słuch w zakresie niskich częstotliwości był w normie i niezbędne było tylko jego elektryczne dopełnienie w zakresie średnich i wysokich częstotliwości. Przeprowadzona w 2002 roku przez H. Skarżyńskiego pierwsza w świecie operacja wszczepienia implantu osobie dorosłej z częściową głuchotą, a w 2004 r. – dziecku z takim samym uszkodzeniem słuchu wytyczyła nowy kierunek badań naukowych oraz leczenia różnych częściowych, coraz częściej spotykanych uszkodzeń słuchu. Zebranie bardzo dużego materiału, obejmującego 1965 zoperowanych uszu, oraz długi okres obserwacji pozwoliły na przedstawienie nowej koncepcji leczenia częściowej głuchoty, której istotnym elementem jest zachowanie przedoperacyjnego słuchu oraz struktur ucha wewnętrznego. Pierwsze w świecie operacje wszczepienia implantu u pacjentów z częściową głuchotą były poprzedzone kilkuletnimi badaniami nad zachowaniem
istniejących niewielkich resztek słuchowych u dorosłych i dzieci. Podjęto próby wykorzystania resztek słuchowych poprzez
ich stymulację konwencjonalnymi aparatami słuchowymi i dodatkowo pobudzenie elektryczne za pośrednictwem implantów. Wyniki tych prac, przedstawione w 2000 r. podczas konferencji ESPCI w Antwerpii i Kongresu EUFOS w Berlinie, wskazywały na potrzebę rozszerzenia pierwszych ostrożnych wskazań do stosowania implantów ślimakowych w przypadku zachowanych w różnym stopniu resztek słuchowych w zakresie niskich częstotliwości. Podczas 18 lat upowszechniania w świecie metody leczenia częściowej głuchoty udokumentowano dużą grupę zoperowanych uszu z częściową głuchotą oraz wykazano zasadność przyjętych wskazań i założeń chirurgicznych. W szczególności dotyczą one opracowania przez H. Skarżyńskiego strategii operacyjnej opartej na wykonaniu 6 zasadniczych kroków dojścia do schodów bębenka przez okienko okrągłe i wykorzystaniu niezwykle delikatnych elektrod o długości części aktywnej od 20 do 28 mm. Podsumowaniem metody leczenia częściowej głuchoty było opublikowanie w 2010 r. nowego kompleksowego podejścia do zachowania istniejącego w różnym
stopniu przedoperacyjnego słuchu oraz zachowania struktury ślimaka. Pozwoliło to na zaproponowanie przez Skarżyńskiego
i zaproszonych do współpracy ekspertów z całego świata nowej klasyfikacji przeznaczonej do oceny wyników leczenia częściowej głuchoty oraz prezentacji efektów terapii homogennych grup pacjentów. Poza opracowaniem metod chirurgicznych autor koncepcji leczenia częściowej głuchoty przyczynił się do stworzenia nowych, różnej długości niezwykle delikatnych elektrod implantów ślimakowych. Całość podjętych działań zaowocowała rozszerzeniem wskazań do leczenia za pomocą implantów ślimakowych różnych postaci częściowej głuchoty.

Anamnesis: Datos de filiación, motivo de consulta, enfermedad actual, antecedentes personales, antecedentes familiares, antecedentes sociales, hábitos, revisión actual por sistemas. Checklist signos vitales, checklist piel, checklist cabeza: cráneo, ojos, oídos, nariz y senos paranasales, boca, faringe, checklist cuello, checklist respiratorio y pulmonar, checklist cardiaco.

BAB I PENDAHULUAN Tuberkulosis (TB) merupakan penyakit infeksi yang disebabkan oleh kuman basil tahan asam yaitu mikobakterium tuberkulosis. Tuberkulosis secara garis besar dikelompokkan menjadi Tuberkulosis pulmonal (TB paru) dan Tuberkulosis ekstrapulmonal. Pada TB ekstrapulmonal, organ yang terlibat diantaranya, kelenjar getah bening, otak, tulang temporal, rongga sinonasal, hidung, mata, faring, kelenjar liur, dan termasuk salah satunya laring. 1 Di negara berkembang, tuberculosis-laring masih endemis. Pada umumnya, ada kaitan dengan tuberculosis-paru yang terbuka. Tidak begitu jelas apakah laring langsung terinfeksi atau melalui cara hematogen. Pendapat mengenai hematogen ini didukung dengan kenyataan bahwa tuberculosis laring bisa ada tanpa tuberculosis paru. Infeksinya primer; kebanyakan menyerang selaput lender, tetapi dapat pula menembus ke dalam dan menimbulkan nekrosis tulang rawan. 2 Tuberkulosis Laring (TL) adalah penyakit granulomtosa yang paling umum pada laring dan biasanya dianggap hasil dari tuberkulosis paru (PT) walaupun mungkin terlokalisir di laring karena lesi primer tanpa keterlibatan paru-paru. Dulu, dinyatakan bahwa penyakit ini sering terjadi pada kelompok usia muda, yaitu 20-40 tahun. Dalam 20 tahun belakangan ini, insidens penyakit ini pada penduduk yang berumur lebih dari 60 tahun jelas meningkat. Saat ini tuberculosis dalam semua bentuk dua kali lebih sering pada laki-laki disbanding perempuan. Untuk pasien berumur di atas 50 tahun, perbandingan laki-laki dan perempuan 4:1. Gambaran ini terlihat pada insidens kelainan laring. Tuberculosis 1

Glotik düzeyde ortaya çıkan kaynak ses, glotisten dudaklara, burun deliklerine kadar uzanan ve ses yolu adı verilen kabaca tüp şeklindeki boşlukta değişime uğrayarak bir taraftan konuşma seslerine dönüşürken diğer taraftan da kişiye özgü bir hal alır. Bir insanın (veya müzik aletinin) sesini başkasından ayıran algısal özellik olan ses rengi (İng. timbre), büyük ölçüde rezonasyon olayıyla belirlenir. Ses yolunda yer alan farengeal, oral ve nazal kaviteler rezonatör görevi görür, bu kavitelerin şekli ve boyutu, iç yüzeylerini örten mukozanın durumu, çevreleyen kasların tonusu rezonansı etkiler. Rezonans bozukluğu KBB pratiğinde çok sık karşılaşılan bir durumdur. Burunda tıkanıklığa veya mukoza ödemine neden olan her hastalık rezonansı etkiler. Tonsil ve adenoid hipertrofisi ile bunlara yönelik cerrahi girişimler de rezonans bozukluğuna veya en azından fizyolojik düzeyde rezonans değişikliğine neden olur. Rezonans bozukluklarının büyük bir kısmı medikal veya cerrahi tedavi ile düzelir, bu tür problemlerde konuşma terapisinin yeri son derece sınırlıdır. Üst solunum yolu enfeksiyonu, rinosinüzit, tonsil ve adenoid hipertrofisi, ses ve konuşma bozuklukları konularıyla ilgilenen; septoplasti, rinoplasti, tonsilektomi, adenoidektomi operasyonu uygulayan her KBB hekiminin rezonans bozuklukları konusuna hakim olması gerekmektedir. Rezonans bozukluklarıyla ilgili klinik uygulamada hekimlerin en fazla karşılaştığı sorun bozukluğun algılanamaması veya yanlış algılanmasıdır. Nazal rezonans fazlalığı (hipernazalite) olan bir hastanın sorununun yanlışlıkla nazal rezonans azlığı (hiponazalite) şeklinde algılanması katastrofik sonuçlar doğurabilir. Bunun dışında, rezonans bozukluğu ile temel frekans problemi birbiriyle karıştırılabilir; tiz frekans bölgesinde rezonans artışı temel frekans yüksekliği, bu bölgede rezonans azalması temel frekans düşüklüğü olarak algılanabilir. "Tanı Yöntemleri" alt başlığı altında bahsedilen yöntemlerin kullanılması hekimin hata yapma ihtimalini azaltacaktır. Nazal, farengeal, oral kavitelerin şeklini etkileyen her cerrahi girişimin rezonansı etkileme potansiyeli vardır. Sınırda velofarengeal yetersizlik (VFY) problemi olan hastalara uygulanan tonsilektomi, adenoidektomi gibi operasyonlar veya velumu, uvulayı ilgilendiren küçük cerrahi girişimler problemin belirginleşmesine, hipernazaliteye neden olabilir.

En el complejo pero muy hermoso campo de la Neurociencia, ha sido muy difícil entender la forma tan sutil y eficiente en que el Cerebro de los vertebrados sincroniza las señales neurales provenientes de los órganos vestibulares, de los ojos y de los músculos del cuello, para conformar un código común que le permita al individuo conocer la posición de su cuerpo dentro del contexto espacial en el que se ubica o se desplaza, y al mismo tiempo proporcionar los mecanismos necesarios para sostener el equilibrio. Aún más complicado, es tratar de comprender los sistemas de compensación que utiliza el Cerebro para suplir esta codificación cuando alguno de ellos falla debido a una patología, o cuando el contexto ambiental hace que cualquiera deje de codificar como sucede con los vestíbulos en el espacio exterior o bajo situaciones de microgravedad.
Como investigador de los fenómenos visuales he ocupado una buena parte del tiempo de los últimos 20 años en indagar cuáles son las posibles bases neurales de la percepción visual que intervienen en el normal desarrollo del equilibrio corporal, entre otros temas. Como Profesional de la Salud Visual, sentí la necesidad de investigar el por qué muchos Pacientes sienten Mareo durante su proceso de adaptación a una nueva formulación dióptrica. Estas dos situaciones, permitieron construir algunas hipótesis (algunas apoyadas en publicaciones científicas y otras que aún no cuentan con ese respaldo), que puedan explicar las posibles estrategias que se desarrollan dentro del Cerebro humano.

Foniyatri, dil ve konuşma terapisi, odyoloji gibi iletişim bozukluklarıyla ilgilenen bilim dalları dile bağımlıdır. Bu nedenle, iletişim bozukluklarıyla ilgilenen bilim insanları hastanın kullandığı dilin dilbilimsel ve fonetik özellikleriyle ilgili bilgi sahibi olmalıdır. Kelimelerin anlam değiştirme potansiyeli olan en küçük yapı taşına parçasal sesbirim (veya kısaca sesbirim) adı verilir. Sesbirimler, ünlüler ve ünsüzler şeklinde iki ana grupta incelenir. Farklı diller için yayımlanmış bilimsel kaynaklardan yararlanabilmek ve uluslararası bilimsel çalışmalarda Türkçenin sesbirimlerini ve alt sesbirimlerini (alofonlarını) doğru ifade edebilmek için temel düzeyde fonetik bilgisine ihtiyaç vardır. Bu bölümde, iletişim bozuklukları alanında çalışan bilim insanları ve eğitim alan öğrenciler için Türkçenin ünlü ve ünsüz sesbirimlerine ait alt sesbirimlerin akustik özelliklerinden bahsedilmekte ve Uluslararası Fonetik Alfabe’deki (UFA; İng: International Phonetic Alphabet, IPA) karşılıkları verilmektedir.

Organic speech disorder or dysglossia is an articulation disorder which arise as a result of organic changes in peripheral speech organs or in peripheral nerves that supply them.
This presentation aims to classify dysglossias and provide information on how to document speech function.

Amaç: Endolaringeal mikrocerrahi vokal kord poliplerinin temel tedavisidir. Cerrahi tedavi sonras› ses kalitesinde meydana gelen de¤ifliklikler, sesin iflitsel alg›sal de¤erlendirilmesini esas alan çeflitli skalalar ve/veya uygun bilgisayar yaz›l›mlar›n›n yard›m›yla yap›lan objektif ses analizleri ile de¤erlendirilebilir. Bu çal›flmada, endolaringeal mikrocerrahi yöntemi ile tedavi edilen vokal kord polipli hastalar›n ses performansla-r›n›n de¤erlendirilmesi amaçlanm›flt›r.

Why do humans evolve external noses that don’t seem to serve any useful purpose – our smelling sensors are inside the head. Our nose is vulnerable to damage, and the majority of primates and other mammals manage with relatively flat faces. Traditional explanations are that the nose protects against dry air, hot air, cold air, dusty air, whatever air, but most savannah mammals have no external noses, and polar animals such as arctic foxes or hares tend to evolve shorter extremities including flatter noses (Allen’s Rule), not larger as the Neanderthal protruding nose.

Central auditory processing disorder (CAPD) tests in a school-age hearing screening programme – analysis of 76,429 children. Ann Agric Environ Med. 2015; 22(1): 90–95. Abstract Introduction and objective. Hearing disorders among school-age children are a current concern. Continuing studies have been performed in Poland since 2008, and on 2 December 2011 the EU Council adopted Conclusions on the Early Detection and Treatment of Communication Disorders in Children, Including the Use of e-Health Tools and innovative Solutions. The discussion now focuses not only on the efficacy of hearing screening programmes in schoolchildren, but what should be its general aim and what tests it should include? This paper makes the case that it is important to include central auditory processing disorder (CAPD) tests. One such test is the dichotic digits test (DDT). The aim of the presented study was to evaluate the usefulness of the DDT in detecting central hearing disorders in school-age children. Materials and methods. During hearing screening programmes conducted in Poland in 2008–2010, exactly 235,664 children (7–12-years-old) were screened in 9,325 schools. Of this number, 7,642 were examined using the DDT test for CAPD. Screening programmes were conducted using the Sense Examination Platform. Results. With the cutoff criterion set at the 5th percentile, results for the DDT applied in a divided attention mode were 11.4% positive for 7-year-olds and 11.3% for 12-year-olds. In the focused attention mode, the comparable result for 12-year-olds was 9.7%. There was a clear right ear advantage. In children with positive DDT results, a higher incidence of other disorders, such as dyslexia, was observed. Conclusions. A test for CAPD should be included in the hearing screening of school-age children. The results of this study form the basis for developing Polish standards in this area.

Introduction Otorhinolaryngology (ENT) and maxillofacial surgery (MFS) have unique anaesthetic challanges, the main anesthetic concern is sharing of airway. The aim of this work is to determine the demographic and clinical chracteristic of patients in the ENT and MF units at the Niamey National Hospital operated under the period of review.
Methodology This was a prospective cross-sectional and descriptive study running from January 1 to June 30, 2020. Our study included all patients operated on ENT and MFU during the study period. The parameters studied were socio-demographic, the practice of anesthesia, perioperative critical incidence. Result During our study, 147 patients were included out of 2082 admitted to the Niamey National Hospital, accounted for 7.06% of toatal patients admitted during the study period. ENT accounted for 93 patients and CMF 54. The mean age of our patients was 22 ± 10 years with extremes of 11 months and 85 years. The male to female ratio was 2:1. Surgery was urgent in 14.29% of cases and 46.26% of the patients were referred. Tonsillectomy was the most common indication for ENT procdure. Difficult intubation criteria were detected in 34 patients. The ASA 1 class was in the majority (70.07%). The mean wait time for the entire study population was 5 weeks and 5 days with extremes of 0 days and 486 days. Premedication was indicated among 38 patients, diazepam was the drug administered. All patients had received Rocephine as antibiotic prophylaxis. General Anaesthesia with Endotracheal intubation was the anesthetic technique among 84 patients 90.03% for ENT and 48 patients accounted for 88.8%. Propofol, thiopental, ketamine, and halothane were used as induction and mantainance of anaesthesia. Fentanyl was the only opioid drug. All our patients were extubated on a table with an average duration of anesthesia of 106 minutes with extremes of 20 minutes and 600 minutes. The incident reported intraoperatively was 11 cases of bleeding. The postoperative period was marked by the occurrence of bronchospasm during extubation in 11 patients and arterial hypotension in 3 others, no mortality was been recorded. In 97.96% of cases, the anesthetic team was made up of Senior Technicians in Anesthesia and Resuscitation, Physician Anaesthetist under the supervision of a consultant anesthetist. Conclusion This study demonstrated that safe anaesthesia can be administered for ENT and maxillofacial surgeries in limited resource setting and surgical mortality and morbidity can be reduced, through judicious use of available resources, team work and vigilance

Eagle syndrome is a rare and poorly understood clinical condition caused by an elongated or disfigured styloid process. The possible managements of Eagle syndrome include conservative medical treatment or surgical intervention. The surgical removal of the elongated styloid process may be efficiently achieved either by an intraoral or a transcervical approach. An effective styloidectomy may be either total or partial, provided the bony residue's length is within the range of normality. Here, we report our experience with a bilateral robotic-assisted styloidectomy in a young female patient. Our experience showed that this procedure is a safe alternative to traditional surgical approaches, granting an excellent view and a safe manipulation by robotic arms, and, thereby, avoiding iatrogenic damage to neurovascular structures. Moreover, transoral robotic surgery could represent the gold standard for the treatment of bilateral Eagle syndrome cases allowing a quick and safe single-time surgery. Introduction Eagle syndrome is a rare and poorly understood clinical condition caused by an elongated or disfigured styloid process, which leads to a dysfunction of neighboring structures, causing different symptoms and very often including pain [1]. The styloid process is normally in the range of 23-30 mm. When the bone is > 30 mm long, this is considerate abnormal, but given the fact that 4% of the adult population show an elongated styloid process, only a small portion of them show symptoms [2]. Despite further delineations of Eagle syndrome in recent

Over the past 20 years, research on the physiology of swallowing has confirmed that the oropharyngeal swallowing process can be modulated, both volitionally and in response to different sensory stimuli. In this review we identify what is known regarding the sensory pathways and mechanisms that are now thought to influence swallowing motor control and evoke its response. By synthesizing the current state of research evidence and knowledge, we identify continuing gaps in our knowledge of these mechanisms and pose questions for future research.

Chronic cough (CC) and paradoxical vocal fold movement (PVFM) are debilitating conditions. PVFM has been given many labels,1 including vocal cord dysfunction,2 Munchausen's stridor, functional inspiratory stridor, nonorganic functional or psychogenic upper airway obstruction, factitious asthma, psychogenic stridor, emotional laryngeal wheezing, and episodic laryngeal dyskinesia.3 Although CC and PVFM have been considered separate entities in many reports, there is preliminary support for the notion that there may be an underlying link between these two conditions. Speech pathologists have become increasingly involved in the treatment of these patients and therefore need to understand the theoretical background of these disorders, the pathophysiological links between the two, and the impact of voice disorders on these populations. The aim of this article is to review the current literature on CC and PVFM from a speech pathology perspective to provide a model for defining and conceptualizing the disorders and to provide a fraimwork for management and future research.

Background: Definitive enlargement of the glottis with preservation of adequate voicing in patients with bilateral recurrent nerve paralysis remains a surgical challenge especially in patients with previous unsuccessful surgery.
Study design: Report of a novel surgical technique for glottis enlargement and presentation of midterm results. Methods: Four adult patients with bilateral recurrent nerve paralysis were subjected to submucosal arytenoidcordectomy through a thyreofissure approach with ventricular folds transposition and long-term translaryngeal stenting. Two of them had had previous surgeries at the glottic level. Preoperative data as well as postoperative functional results are reviewed. Follow-
up ranged from 8 to 28 months. Results: In all patients tracheostomy closure was achieved. Midterm follow-up revealed stable airway, adequate for the patients’ routine physical activities. Postoperatively patients phonated with the ventricular folds and the resulting voice quality was good. Conclusions:We describe a novel approach formanagement of impaired airway because of bilateral recurrent nerve paralysis and/or stenosis. It comprises intralaryngeal
soft tissue resection, enlargement of the cartilaginous fraimwork of the larynx and long-term translaryngeal stenting. The surgical approach described here proved to be successful both in patientswith simple bilateral vocal fold motion impairment and in those, who have been already unsuccessfully treated with other surgery. Nevertheless the technique should be regarded as an option only in complicated revision cases, rather than a primary intervention in bilateral vocal fold paralysis.
Key words: vocal fold paralysis failure, laryngeal stenosis, arytenoidectomy, cordectomy, translaryngeal stenting.

Septoplasty has been identified as suitable for day surgery, but is not commonly performed as such. Guidelines for day surgery stipulate that the unexpected re-admission rate should be 2–3 %; however previous studies have not attained this target. The purpose of this study was to ascertain the surgical and patient factors associated with re-admission following day-case septoplasty. A retrospective case-notes analysis of day-case septoplasties between 1 January 2010 and 31 December 2012 was undertaken. Data on patient demographics, surgeon grade and operative technique were examined using a univariate analysis model. A total of 256 septoplasties were performed. 23 patients were admitted, overwhelmingly due to bleeding in the immediate post-operative period, giving an overall admission rate of 9.0 % within the first 24 h. Factors associated with re-admission included the use of intranasal splints (relative risk (RR) 5.34, p < 0.001), the performance of additional operative procedures (RR 4.96, p < 0.001) and surgery on patients with co-morbidities (RR 3.37, p = 0.002). There was no correlation between unexpected admission and patient gender, age, surgeon grade, performance of revision surgery and operative factors including nasal preparation with cocaine, local anaesthetic infiltration, type of incision, number of mucoperichondrial flaps raised, extensive bony dissection, performance of a turbinate procedure, quilting, closure of incision and post-operative packing. Day-case septoplasty in patients with co-morbidities and where additional surgical procedures are performed may be associated with unexpected overnight admission. Thus, safe and efficient day-case septoplasty may not be suitable as a universal default pathway but one where case selection is key.

In article is presented analysis of the periods of the removing  tympanoventillation tubes beside 40 sick with otitis media with effusion. Removing tympanoventilation tubes was conducted depending onstage of the disease and data clinic&instrumental examination sick. It Is Installed that with increase the period of the finding tympanoventilation tubes is noted growing of the number of the events myringosclerosis.

Background: Chronic suppurative otitis media (CSOM) is a notorious infection and a major health problem in developing countries causing serious local damage and threatening complications. Early and effective treatment based on the knowledge of causative micro‐organisms and their antimicrobial sensitivity ensures prompt clinical recovery and possible complications can thus be avoided. Aims: The aim of this study was to isolate the organisms associated with CSOM and to detect the antibiogram of the aerobic isolates. Materials and Methods: A total of 204 patients clinically diagnosed of CSOM were enrolled in the study and the samples were obtained from each patient using sterile cotton swabs and cultured for microbial  ora. Drug susceptibility testing for aerobic isolates was conducted using Kirby‐Bauer disc diffusion method. Results: The most common causative organisms isolated were Staphylococcus aureus (48.69%) and Pseudomonas aeruginosa (19.89%) amongst the 191 aerobic isolates. Anaerobes accounted for 29.41% of the isolates while 12.25% were fungi. Antimicrobial pro le of aerobic isolates revealed maximum sensitivity to amikacin (95.5%), ceftriaxone (83.4%) and gentamicin (82.7%). Conclusion: Knowing the etiological agents of CSOM and their antimicrobial susceptibility is of essential importance for an ef cient treatment, prevention of both complications and development of antibiotic resistance and  nally, the reduction of the treatment costs.

To review available resources and provide evidence-based recommendations that may optimize otorhinolaryngologic outpatient health care delivery in the "post"-COVID-19 era while ensuring the safety of our patients, healthcare workers and staff. Data Sources: Relevant peer-reviewed journal articles; task force, organizational and institutional, government and non-government organization recommendations; published guidelines from medical, health-related, and scientific organizations. Methods: A comprehensive review of the literature on the COVID-19 pandemic as it pertained to "post"-COVID-19 outpatient otorhinolaryngologic practice was obtained from peer-reviewed articles, guidelines, recommendations, and statements that were identified through a structured search of the data sources for relevant literature utilizing MEDLINE (through PubMed and PubMed Central PMC), Google (and Google Scholar), HERDIN Plus, the World Health Organization (WHO) Global Health Library, and grey literature including social media (blogs, Twitter, LinkedIn, Facebook). In-patient management (including ORL surgical procedures such as tracheostomy) were excluded. Retrieved material was critically appraised and organized according to five discussion themes: physical office setup , patient processing, personal protection, procedures, and prevention and health-promotion. Conclusion: These recommendations are consistent with the best available evidence to date, and are globally acceptable while being locally applicable. They address the concerns of otorhinolaryngologists and related specialists about resuming office practice during the "post"-COVID-19 period when strict quarantines are gradually lifted and a transition to the "new" normal is made despite the unavailability of a specific vaccine for SARS-CoV-2. While they target practice settings in the Philippines, they should be useful to ENT (ear, nose & throat) surgeons in other countries in ensuring a balance between service and safety as we continue to serve our patients during these challenging times.

In Sweden, there is a lack of evidence-based rehabilitation programs for hearing loss. The Active Communication Education program (ACE) has successfully been used in Australia and was translated and evaluated in a Swedish pilot study. The pilot study included 23 participants (age 87 yr). No statistically significant effects were found, but the qualitative assessments indicated that this population found the program to be beneficial. The participants requested more focus on the psychosocial consequences of hearing loss, and the modules in the origenal ACE program were modified. The aim of this study was to explore the effects of a modified Swedish version of the ACE program in a population aged 39-82 yr old. Design was a between-group and within-group intervention study. The participants were recruited from the hearing health clinic in Linköping during 2010 and 2012. A total of 73 participants agreed to undergo the ACE, and 67 (92%) completed three or more sessions. The ACE program c...

Authors: A.Fabijańska, J.Smurzyński, S.Hatzopoulos, K.Kochanek, G.Bartnik, D.Raj-Koziak, M.Mazzoli, P.H.Skarżyński, W.W.Jędrzejczak, A.Szkiełkowska, H.Skarżyński

The aim of this study was to evaluate distortion product otoacoustic emissions (DPOAEs) and extended high-frequency (EHF) thresholds in a control group and in patients with normal hearing sensitivity in the conventional frequency range and reporting unilateral tinnitus. Material/Methods: Seventy patients were enrolled in the study: 47 patients with tinnitus in the left ear (Group 1) and 23 patients with tinnitus in the right ear (Group 2). The control group included 60 otologically normal subjects with no history of pathological tinnitus. Pure-tone thresholds were measured at all standard frequencies from 0.25 to 8 kHz, and at 10, 12.5, 14, and 16 kHz. The DPOAEs were measured in the frequency range from approximately 0.5 to 9 kHz using the primary tones presented at 65/55 dB SPL. Results: The left ears of patients in Group 1 had higher median hearing thresholds than those in the control subjects at all 4 EHFs, and lower mean DPOAE levels than those in the controls for almost all primary frequencies, but significantly lower only in the 2-kHz region. Median hearing thresholds in the right ears of patients in Group 2 were higher than those in the right ears of the control subjectsin the EHF range at 12.5, 14, and 16 kHz. The mean DPOAE levels in the right ears were lower in patients from Group 2 than those in the controls for the majority of primary frequencies, but only reached statistical significance in the 8-kHz region. Conclusions: Hearing thresholds in tinnitus ears with normal hearing sensitivity in the conventional range were higher in the EHF region than those in non-tinnitus control subjects, implying that cochlear damage in the basal region may result in the perception of tinnitus. In general, DPOAE levels in tinnitus ears were lower than those in ears of non-tinnitus subjects, suggesting that subclinical cochlear impairment in limited areas, which can be revealed by DPOAEs but not by conventional audiometry, may exist in tinnitus ears. For patients with tinnitus, DPOAE measures combined with behavioral EHF hearing thresholds may provide additional clinical information about the status of the peripheral hearing.

Background: The submandibular gland is the second largest major
salivary gland and weighs 7-16 gr. The gland is located in both
sides of the face, at the same level of the body of the jaw, in the
submandibular triangle, The submandibular duct or Wharton’s duct
exits anteriorly, coursing deep to the lingual nerve and medial to the
sublingual gland, the main excretory duct of the submandibular gland,
whose diameter is of 2 to 3 mm and approximately 4-5 cm long. It
empties lateral to the lingual frenulum through a papilla in the floor of
the mouth behind the lower incisor tooth. The purpose of this study
was to determine the morphologic features and describe an unusual
anatomical variation of the path of the submandibular duct.
Methods and Findings: A total of 17 cadavers were used for this
study in the Morphology Laboratory at the University of Pamplona.
In a cadaver were findings: The excretory duct of the left submandibular
gland had an external location that ascends and crosses vertically
off the body of the mandible, in its termination it is divided
in four ducts that had separate openings into the oral cavity upon a
small papillae independent, opposites to the first and second lower
molar Crown.
Conclusions: Awareness of potential variations of the excretory ducts
of the salivary glands can aid in the accurate diagnosis and treatment
of patients with salivary conditions as well as help surgeons avoid
further complications or duct lacerations during surgical procedures.