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Ptok M.,Klinik fur Phoniatrie und Padaudiologie
HNO | Year: 2014

Background: Before the era of objective audiometric procedures, the primary aim of subjective audiometric procedures was determination of the hearing threshold, e.g. to assess hearing aid indications. Nowadays, the results of objective audiometric procedures play a major role in hearing threshold determination in children. Contrastingly, subjective audiometric procedures are also employed in order to verify, or acquire an objective picture of, social hearing abnormalities evident from the children’s anamneses. Methods: A selective literature search was conducted in the PubMed and Scopus databases and current textbooks were also considered. Results: Subjective audiometric procedures for children employ both nonlinguistic and linguistic stimuli. Procedures can differ in many ways and it can be differentiated between, for example, observational or behavioural audiometry and procedures in which the children are explicitly instructed on how to react to signals. Discussion: Several subjective audiometric procedures have been developed to examine the hearing and listening skills of children. Some of these tests differ significantly in terms of their intended application, test construction and test quality criteria. Only a detailed understanding of the particular subjective audiometric procedure being applied enables formulation of the“correct” questions; which, providing the child is willing to cooperate, can also be specifically answered using the test. © 2014, Springer-Verlag Berlin Heidelberg.

Animal experiments have shown that after specific nerve traumatization, neuromuscular electrostimulation (NMES) can promote nerve regeneration and reduce synkinesia without negatively interfering with normal regeneration processes. NMES is used routinely in physical rehabilitation medicine. This systematic literature search in the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, the DAHTA database, the Health Technology Assessment Database and MEDLINE or PubMed considered studies on the use of NMES in otorhinolaryngology that have been published in German or English. The search identified 180 studies. These were evaluated and relevant studies were included in the further evaluation. In the fields of otorhinolaryngology and phoniatry/paediatric audiology, clinical studies investigating the effects of NMES on facial and laryngeal paresis, as well as dysphonia and dysphagia have been carried out. The evidence collected to date is encouraging; particularly for the treatment of certain forms of dysphagia and laryngeal paresis.

Meyer S.,Klinik fur Phoniatrie und Padaudiologie | Ptok M.,Klinik fur Phoniatrie und Padaudiologie
Laryngo- Rhino- Otologie | Year: 2012

Laryngeal Neuropathy and Irritable Larynx Syndrome: Synonyms or Distinct Entities Background: The term laryngeal neuropathy (LN) has first been used in veterinary medicine to describe an idiopathic and typically exercise induced inspiratory noise in horses. Nowadays, the term is often used in relation with intermittent vocal cord pareses in humans. Some authors use the term irritable larynx syndrome (ILS) in a similar context. This article reviews the state of knowledge regarding LN and ILS and discusses the somewhat confusing terminology. Method: For this systematic review a selective literature research in PubMed has been carried out. Results: 35 articles were found, which report on LN in animals and 17 articles reported on humans. 4 of these articles used the term irritable larynx syndrome. Discussion: Laryngeal neuropathy in horses usually affects the left recurrent laryngeal nerve and results in decreased vocal cord abduction and an inspiratory roaring or whistling noise, particularly during exercise. In dogs LN has been reported to also occur bilaterally. In association with humans LN has not been defined clearly in the literature. The term ILS on the other hand has only been used in relation to humans. The term describes a hypersensitivity of the laryngeal structures towards external stimuli, which causes symptoms such as dyspnea or cough among others. Sufficient knowledge does not exist for either of the 2 diseases, ILS or LN. As of yet, the term LN should not be used in human medicine to describe according symptoms of unknown aetiology. The term laryngeal movement disorder seems a lot more appropriate. The symptom oriented term irritable larynx syndrome also seems suitable to describe laryngeal hypersensitivity appropriately. © 2012 Georg Thieme Verlag KG Stuttgart New York.

Meyer S.,Klinik fur Phoniatrie und Padaudiologie | Ptok M.,Klinik fur Phoniatrie und Padaudiologie
HNO | Year: 2011

Background: The term Mondegreens describes misperceptions as defined by "slips of the ear", denoting that an utterance is perceived differently to what has actually been said. The analysis of these misperceptions permits a deeper insight into speech processing in the human brain. Method: A selective literature research in PubMed has been carried out for this systematic review. Results: Altogether, 24 publications were found addressing the issue of auditory misperceptions. Discussion: The analysis of Mondegreens enables a characterization of the different levels of speech processing as well as the processing steps involved. The hard of hearing in particular suffer from misperceptions. Therefore, it should be considered whether listening programs could be helpful in combination with hearing aids. © 2011 Springer-Verlag.

Meyer S.,Klinik fur Phoniatrie und Padaudiologie | Ptok M.,Klinik fur Phoniatrie und Padaudiologie
HNO | Year: 2011

Background: Swallowing as a neurophysiological process has recently attracted much interest. Knowledge of cortical involvement in particular has raised hope that a novel form of dysphagia therapy might be possible by means of cortical stimulation. Method: For this systematic review a selective literature research in PubMed has been carried out. Results: The cortex is not only involved in the initiation of swallowing, but also during pharyngeal and esophageal phases. In addition, there appears to be a hemispheric dominance both for swallowing and its individual phases. Discussion: In light of recent study results, the theory of the pattern generators' autonomy must be abandoned, since pattern generators seem to be influenced rather by the cortex. During the recovery of unilateral impairments, the intact hemisphere seems to play a significant role due to cortical reorganisation processes. Several studies indicate that repetitive transcranial stimulation, and thereby modulation of cortical areas as a means of dysphagia therapy, could be beneficial. © 2010 Springer-Verlag.

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