Background Good hearing is a fundamental skill that allows children to develop properly, both socially and intellectually. In contrast to defects in inner ear function, however, auditory processing disorders (APDs)–which can affect up to 2–3% of school-children–are not easily identified with basic screening programs and must be diagnosed using special tests. Although such psychoacoustic tests are available, the scores achieved depend highly on the social, cultural, and linguistic characteristics of the population, and norms must be established for each population separately. Reference values are still lacking for the Polish population, especially for children in school-age, so that practitioners must interpret test scores themselves, often intuitively or using potentially biased thresholds from other countries. Materials and methods We investigated a sample of 94 Polish schoolchildren with normal hearing, divided into four age groups: from 7 years-olds to 10 years-olds. All children had no speech or language development disorder, learning problem, or symptom of APD. Participants were volunteers who had previously taken part in a large screening study. The group consisted of 56 girls (60%) and 38 boys (40%) with an average age of 8.6 years (SD = 1.1). The test battery included the Duration Pattern Test (DPT), Frequency Pattern Test (FPT), Time-Compressed Speech Test (CST), and Dichotic Digit Test (DDT). Results The scores on all tests increased consistently with age. The difference between each age-group for DPT, CST, and left- and right-ear DDT tests was significant (Kruskal–Wallis test, p -values = 0.002, 0.006, 0.005, 0.020, respectively), but the effect of age on the FPT test was not ( p -value = 0.143). The analysis showed a clear and significant separation between a merged group of ages 7 and 8 and another of ages 9 and 10. We, therefore, propose, for each test, separate reference values for these two particular age-groups. Using thresholds based on a 10% quantile, we offer the following reference values for ages 7–8 and 9–10 respectively: DPT, 28.5% and 53.8%; FPT, 18.5% and 27.5%; CST, 68.6% and 77.2%; left-ear DDT, 34.3% and 52.5%; right-ear DDT, 56% and 72.5%. Conclusion The scores on psychoacoustic tests to diagnose APD differ between cultures and linguistic backgrounds. Clinicians should, therefore, use norms that have been designed for the population most similar to their patients. Here, we report the use of a test battery designed for the Polish language that accounts for various aspects of APD when screening school children. Together with a full methodology of those tests, we provide norms that can be used as cut-offs in clinical diagnosis. Practitioners are invited to use them to obtain more accurate, evidence-based decisions.
Surgical treatment of sulcus should be considered in patients with severe voice problems; however, the end results are not always entirely satisfactory.
PurposeThis is a retrospective study to evaluate the results of surgical treatment of patients with pathological sulcus vocalis.MethodsThirty-six patients with pathological sulcus underwent surgery and in 33 cases were performed additional injection laryngoplasty. The pre- and postoperative evaluation of patients included the GRBAS scale, stroboscopic, and objective acoustic voice assessment. The Voice Handicap Index questionnaire (VHI-30) was also used and the scores were obtained from 33 patients.ResultsThe stroboscopic evaluation showed significant improvement of amplitude, mucosal wave, and glottal closure after treatment (p < 0.001). The VHI-30 scores decreased considerably indicating improvement due to the treatment for all aspects measured by VHI (p < 0.05, or p < 0.01). In all domains of GRBAS scale, the differences between preoperative and postoperative assessment were statistically significant (p < 0.001). We observed a significant change in Shim and APQ parameters (p < 0.05). Improvement was also observed in the sAPQ parameter, but it was not statistically significant (p = 0.051). For the remaining acoustic parameters, no changes were observed.ConclusionsThe surgical procedure with supplementary injection laryngoplasty of the vocal folds is a good treatment option for pathological sulcus vocalis. The post-treatment self-assessment indicates the significant improvement in VHI, just as perceptual–acoustic evaluation of voice does. Patients with pathological sulcus frequently present with amplitude disturbances, what explains their significant improvement after treatment.
Journal of International Advanced Otology requires and encourages the authors and the individuals involved in the evaluation process of submitted manuscripts to disclose any existing or potential conflicts of interests, including financial, consultant, and institutional, that might lead to potential bias or a conflict of interest. Any financial grants or other support received for a submitted study from individuals or institutions should be disclosed to the Editorial Board. To disclose a potential conflict of interest, the ICMJE Potential Conflict of Interest Disclosure Form should be filled in and submitted by all contributing authors. Cases of a potential conflict of interest of the editors, authors, or reviewers are resolved by the journal's Editorial Board within the scope of COPE and ICMJE guidelines. The Editorial Board of the journal handles all appeal and complaint cases within the scope of COPE guidelines. In such cases, authors should get in direct contact with the editorial office regarding their appeals and complaints. When needed, an ombudsperson may be assigned to resolve cases that cannot be resolved internally.
Acoustic analysis of voice is a reliable method for objective assessment of voice quality after applied treatment. Injection of the hyaluronic acid into the vocal fold improves the quality of voice in patients suffering from glottic insufficiency.
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