No abstract

Objective: The purpose of this study was to identify voice risk factors for female kindergarten teachers and nurses in Heraklion, Crete. Patients and Methods: A questionnaire consisting of voice use and lifestyle activities was given to 200 kindergarten teachers in Heraklion, Crete, of which 151 were returned (75.5%). A group of 89 nurses served as the control group. Both groups also completed the Greek version of the Voice Handicap Index (VHI-G). Results: Kindergarten teachers sing more often, speak loudly more often when they are at work and present with more infections of the upper respiratory tract compared to nurses. They talk less than 30 min per day on the phone, drink less alcohol and water and smoke less in comparison with nurses. The median VHI-G score for the kindergarten teachers was significantly higher than that for the nurses. Conclusion: The results suggest that there is a difference in the factors that may be responsible for the appearance of voice problems in kindergarten teachers and in nurses. For kindergarten teachers, the risk factors for voice disorders are primarily related to vocal load factors and for nurses appear to be lifestyle-related more than voice use alone.

Voice disorders often remain undiagnosed. Many self-perceived questionnaires exist for various medical conditions. Here, we used the Greek Voice Handicap Index (VHI) to address the aforementioned problem. Everyone can fill in the VHI questionnaire and rate their symptoms easily. The innovative feature of this research is the global cut-off score calculated for the VHI. Therefore, the VHI is now capable of helping clinicians establish a more customizable treatment plan with the cut-off point identifying patients without normal phonation. For the purpose of finding the global cut-off point, a group of 180 participants was recruited in Greece (90 non-dysphonic participants and 90 with different types of dysphonia). The voice disordered group had higher VHI scores than those of the control group. In contrast to previous studies, we provided and validated for the first time the cut-off points for all VHI domains and, finally, a global cut-off point through ROC and precision-recall analysis in a voice disordered population. In practice, a score higher than the well-estimated global score indicates (without intervention) a possible voice disorder. Nevertheless, if the score is near the threshold, then the patient should definitely follow preventive measures.

Ambient noise in classrooms may present a serious obstacle to the academic achievement of children. There is relatively little information on noise levels in teaching facilities in Greece and particularly in the island of Crete. The purpose of this study was to provide objective data on the internal noise levels inside kindergartens in Crete. The study was conducted in the city of Heraklion in the island of Crete, Greece. Ten kindergartens were selected and a total of 18 classrooms were chosen. Noise levels were measured in occupied and unoccupied classrooms. Noise levels in occupied classrooms ranged from 71.6 to 82.9 dBA with an average of 75.8 dBA. Noise levels in empty classrooms varied from 48.2 to 59.6 dBA with an average of 53.1 dBA. All values are well above international standards. Excessive classroom noise seems to be very common in kindergartens. Results may indicate that school facilities are not built in compliance with international standards. School administrators and local authorities should become aware of the problem, and make any necessary interventions to improve the learning capabilities of children.

The aim of this study was to present data of the cochlear implant programme in Crete. Our series consists of 51 patients, 35 adults and 16 children, in a nine year period. The average age of our patients was 31 years (range from three to 68). The average duration of deafness among our patients was seven years (range from two to 22). Our series included 32 postlingual patients and 19 prelingual patients. The cause of deafness in our series was unknown in approximately 40 per cent of cases. Standard selection criteria and operative techniques were used for all cases. Postoperative programming and rehabilitation were performed according to the individual needs of each patient. Implantation was successful in all patients except one who had to undergo a second operation with good results. No major postoperative complications were noted, while minor complications included temporary facial weakness and undesired stimulation of the facial nerve during implant function in two and three patients, respectively. All patients showed significant improvement in perception and discrimination of sound and speech. Better results have been noted in prelingual patients under the age of six, as well as in postlingual adults with a recent history of deafness. As cochlear implant technology evolves and surgical techniques continue to improve, our department will continue its efforts to provide effective hearing rehabilitation of deaf children and adults in Crete.