Articles

 Introduction

Abstract

Abstract
Indirect laryngoscopy is the standard procedure in ENT evaluation of the hoarseness. Not so simple, it can be very difficult to perform in situations of hypersensitive gag reflex or some anatomical reasons for difficult larynx exposure.
The results of prospective clinical study carried out over the last three years are presented. The total of 2.19 % (132 of 6020) of patients treated at our Phoniatric Department (Communication Disorders Care Center, ENT & MFS Clinic, Clinical Center of Serbia, Belgrade) were referred by ENT specialists with no visualized vocal folds, even after use of topical anesthestics. .
Improved technique of indirect laryngoscopy was performed successfully in 106 patients (80 %), endovideolaryngostroboscopy done in improved technique was helpful in vocal fold visualization in 24 patients (19 %) while only 2 patients were sent to direct microlaryngoscopy.
The precise description of this method is presented.. The total of 18 % of patients were free of any organic laryngeal pathology, however 16 % of the patients were diagnosed with malignant laryngeal diseases - both results being strong cost- effective reasons for recommending the technique to be used in everyday office-based ENT practice.
Key words: Laryngeal imaging, Original method

In our Phoniatric Dpt. everyday practice we try to keep specific multidisciplinary approach to the communication disorders, that includes an expert team using modern technology.

Over the last six years we have treated 110 singers ( 3% of all new cases) and the results of their diagnostic and therapeutic management are presented here. There were 67 women and 43 men, 41 were smokers and 69 nonsmokers. The singing genres included 24 pop, 41 folk, 8 ethnic, 29 choral and 8 opera singers. The therapy success was compared with the demographic parameters, level of education and music genres across the subjects.

A precise history, clinical examination, endovideolaryngostroboscopy and multidimensional computer analysis of voice and speech was carried out by two phoniatricians, two logopeds, two nurses and one clinical psychologist. Additional consultations were carried out by audiologists, allergists, endocrinologists, chest physicians, gastroenterologists and neurologists where necessary.

We suggest that the gold standard is conservative therapy, with phonosurgery if conservative measures fail.

We also suggest that an annual systematic examination is optimal in preventing disease in professional singers.

Key words: multidisciplinary approach, annual systematic examination

ABSTRACT

Nonverbal aspects such as prosody and facial expression are contributing better understanding in communication. Interdisciplinary approach to these phenomena is essentially in evaluation of unilateral brain damaged patients.

Three groups of participants were evaluated in prospective clinical trial. One group of thirty patients with right hemispheric deficit (RHD), second group of thirty patients with left hemispheric deficit ( LHD) and the group of thirty healthy persons (CG).

Abstract

Diagnostic management of the cause of the hoarseness is determined by the fact that    phonation is integral, complex function of the whole body. At the very first one should always bear on mind that audio- vocal system is the basis of very complex interpersonal communication processing. Between the acoustic input and vocal output there is central nervous system with a number of parallel and sequential brain activities, mostly unexplained.