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Biomedical subjects

F Rosanowski

Publications and source records attributed to F Rosanowski.

At least 19 recordsLinked to original sources
PubMed2007

[Critical factors for subjective burden of mothers of children with developmental language disorders].

BACKGROUND: In earlier studies, it was found that mothers of children with developmental language disorders had a higher incidence of anxiety and depression in comparison to the normal population. This study concentrated on the following questions: is the perceived stress, anxiety and depression of mothers with children with developmental language disorders higher than in the normal population, even for those mothers who are not exposed to any further stressors? and what environmental factors play an important role in the mental health of the mothers? MATERIALS AND METHODS: A total of 90 mothers (aged 32.9+/-4.7 years) of preschoolers diagnosed with a developmental language disorder, but with otherwise normal development, participated in the study. The mental health of the mothers was assessed using the Perceived Stress Scale (PSS) and the German version of the Hospital Anxiety and Depression Scale (HASD-D). Environmental factors were captured by a structured anamnestic procedure. Predictors of mental health were determined using multivariate regression analysis. RESULTS: The entire sample demonstrated significant levels of stress, anxiety and depression. In comparison to the standardized values, those mothers of children with developmental language disorders who were not exposed to any further stressors, were also shown to have significantly higher rates of stress and depression on the scales used, although not significantly higher levels of anxiety. A significant predictor of positive overall mental health of the mothers was the extent of adequate support in child rearing. CONCLUSIONS: Health professionals dealing with children with developmental language disorders must reckon with a considerable number of mothers whose mental health is negatively affected. When treating a child with a developmental language disorder, measures to improve the mother's state of well-being should be considered, including counseling and self-help groups.

Adult↗
PubMed2006

[Hearing impairment in children and adolescents with Down's syndrome].

BACKGROUND: There are controversial opinions about the incidence of hearing impairment of children and adolescents with Down's syndrome as an additional cause for obstruction in social and communicative live. Next to congenital diseases of the inner ear, functional limitations can often lead to conductive hearing disorders in patients with Down's syndrome. PATIENTS AND METHODS: The hearing ability, otoscopic and audiometric characteristics of 115 patients aged 3.2+/-2.9 years were analysed retrospectively over 42 months. RESULTS: A total of 86 children showed morphologic otoscopic peculiarities: transitory evoked otoacoustic emissions (TEOAE) were often non-reproducible, even in patients with normal hearing abilities(14.1% of cases), and were not evaluable in 32.8% of cases. Half of the patients showed hearing loss, 82% of whom suffered from a conductive hearing loss, 6.9% from a combined, and 8.6% from isolated sensorineural hearing loss. Hearing loss was first diagnosed when the children were 4.6+/-3.4 years old. CONCLUSION: The frequent occurrence of hearing loss justifies and requires an early and continuous pedaudiological examination. As a common screening examination, TEOAE is limited due to its cost, however, it fulfils its purpose as a means of distinguishing healthy children from those with possible hearing disorders. In most cases, objective and subjective audiometric methods must be combined in order to precisely define the hearing ability.

Adolescent↗
PubMed2006

[Voice Handicap Index (VHI) in inpatient voice rehabilitation medicine].

BACKGROUND: The focus of this study was to determine if the Voice Handicap Index (VHI) is a valid tool for evaluating an inpatient voice rehabilitation program. PATIENTS AND METHODS: A total of 39 German-speaking patients were asked to complete a German version of the VHI questionnaire at the beginning and 3 months after attending a voice rehabilitation program on an inpatient basis at the Bad Gögging voice center. The data collected were documented and assessed using Microsoft Excel and MATLAB. RESULTS: A significant reduction of the VHI summary score was achieved by 10 of 39 patients. An increased number of voice therapy sessions before the program diminished (!) the VHI score 3 months after the program. Work disability because of the dysphonia before the beginning of the voice rehabilitation program showed no significant correlation with the VHI score. CONCLUSIONS: At present, the VHI cannot be regarded as a reliable measure to evaluate benefit derived from completing a voice rehabilitation program on an inpatient basis. Apparently, numerous prior treatment regimens constitute a negative prognostic criterion for rehabilitation success as measured subjectively by the VHI.

Adult↗
PubMed2006

[Subjective aspects in mothers of speech impaired children].

OBJECTIVE: The purpose of this study was to evaluate the subjective burden in mothers of speech impaired children against the presence or absence of emotional disorders such as anxiety and depression. METHODS: A total of 89 mothers (age 33.3+/-5.5 years, range: 19.6-43.8 years) of 89 speech impaired preschool children (23 girls, 66 boys, age: 3.9+/-1.5 years, range: 1.6-7.1 years) were examined. Screening for a depressive or anxiety disorder was performed using the German version of the Hospital Anxiety and Depression Scale HADS-D. The "Short Questionnaire on Current Burden" (Kurzfragebogen zur Aktuellen Belastung, KAB) was used to measure the level of perceived subjective burden at the time of the investigation. RESULTS: A higher score in the KAB test occurred significantly more often in mothers with a positive HADS depression/anxiety subscale result than in those with a negative one. CONCLUSIONS: There is a need for specific assessment of wellbeing in mothers of speech impaired children. In clinical practice, one may restrict oneself to the use of a screening test for anxiety and depression.

Adult↗
PubMed2006

[Prosthetic voice rehabilitation after laryngectomy. Failures and complications after previous radiation therapy].

BACKGROUND: Indwelling voice prostheses are state of the art for post-laryngectomy voice rehabilitation. The aim of this study was to identify the impact of radiation prior to tracheoesophageal puncture on success rate and complications. PATIENTS AND METHODS: We undertook a retrospective study of 145 patients who had undergone prosthetic voice restoration between 1990 and 2002 (Provox) and Provox2). Risks of functional failure and complications in 17 patients with previous radiation therapy were compared to those of 128 patients without such therapy. RESULTS: Previous radiation increased not only the risk of functional failure by 2.9 (P=0.023), but also the risk of shunt-related complications such as aspiration around the prosthesis (1.51; P=0.046), widening of the shunt (2.32; P=0.014), esophageal (2.51; P=0.013) or tracheal (3.29; P=0.0023) dislocation of the prosthesis and spontaneous (2.51; P=0.047) or surgical closure (3.76; P=0.037) of the shunt. CONCLUSION: Primary tracheoesophageal puncture during laryngectomy is recommended in cases without previous radiation therapy, especially when post-laryngectomy radiation is likely. In patients with previous radiation therapy, generally good success rates decrease, however, without absolute contraindication of tracheoesophageal puncture. These results may affect salvage surgery concepts.

Adult↗
PubMed2006

[The influence of conductive hearing loss on DPOAE-threshold. The effect of an individually optimized stimulation].

BACKGROUND: The DPOAE-threshold, estimated from extrapolated I/O functions, allows an objective assessment of the mechanical sensitivity of the inner ear. In children, the specificity of this diagnostic tool is impaired by conductive hearing loss. METHODS: In this study, we propose an individual optimization of the primary tone level ratio. This procedure allows the detection of a conductive hearing loss that can be accounted for when estimating the DPOAE-threshold. By means of a simulation using DPOAE-data from 22 normally hearing subjects, the effects of this procedure on the estimation of the DPOAE-threshold are examined. RESULTS: An individually optimized DPOAE stimulation distinctly improves the signal-to-noise ratio of the DPOAE which enables an estimation of the DPOAE-threshold for sound conductive losses up to 15 dB. The DPOAE-threshold only worsens in individual cases. CONCLUSIONS: An individually optimized stimulation paradigm may improve the specificity of inner ear diagnostics with the DPOAE-threshold. A clinical evaluation of the method in children, however, is necessary.

Acoustic Stimulation↗
PubMed2005

[Physical complaints in dysphonic patients].

BACKGROUND: In previous studies, patients with benign organic and functional voice disorders were shown to suffer from physical complaints. The present study focuses on a specific nosologic classification of these disorders in the sense of diagnosing a somatoform illness. PATIENTS AND METHODS: Eighty patients (50 women, 30 men) aged 44+/-11 years (18-60), suffering from various voice disorders (functional: n=18 women, n=13 men; organic: n=32 women, n=17 men), were examined after informed consent. Physical complaints were assessed using the Giessen Complaint Questionnaire GBB-24. Age and gender matched normal controls were taken from the literature. Data were analyzed using the non parametric two-by-two four-field-test. RESULTS: The individual diagnosis of dysphonic women showed pathologic values in all subscales except limb complaints. The individual diagnosis of men showed pathologic values in the limb complaints subscale (P<0.05). When comparing functional and organic disorders, no significant difference (P>0.05) was found in neither of the gender groups. DISCUSSION AND CONCLUSIONS: Depending on gender and type of voice disorder, dysphonic patients suffer from different physical complaints. Both patients with functional and organic disorders are affected. Therefore, it does not seem justified to classify functional voice disorders as somatoform disorders.

Adolescent↗
PubMed2005

[Determination of subjective impairment in dysphonia. A methodological comparison].

OBJECTIVE: The purpose of this study was to estimate the correlation between the voice handicap index (VHI) and the voice related quality of life (VRQOL) questionnaire with respect to gender and diagnosis (functional vs organic dysphonia). MATERIALS AND METHODS: A total of 52 German speaking patients aged 48.8+/-22.0 years suffering from dysphonia of different benign etiologies (functional dysphonia: 18 women, 9 men; organic dysphonia: 13 women, 12 men) completed German versions of both the VHI and the VRQOL questionnaire without prior information on their individual diagnosis. Another 52 individuals without voice complaints served as age and sex matched controls. Complete data sets of all participants were analyzed using the Microsoft Excel and MATLAB software packages. RESULTS: The results of both questionnaires correlate at a significant level, both for total score (r=-0.9) and the subscores (r=-0.74-r=-0.84) with only slight differences when comparing women and men and patients with functional and organic voice disorders. CONCLUSIONS: Both questionnaires provide very similar results. Thus, for clinical purposes, it seems justified to restrict oneself to using only one of the questionnaires. Whenever basic information on the patients' self perception of a voice disorder is required, the VRQOL questionnaire with only ten items may be easier to handle than the VHI questionnaire with 30 items.

Disability Evaluation↗
PubMed2005

[Quality of life and voice handicap of laryngectomees using tracheoesophageal substitute voice].

BACKGROUND: Health-related quality of life (QoL) and subjective health have become popular constructs for the evaluation of both efficacy and efficiency of diagnostic and therapeutic procedures in medicine. QoL is considered a multidimensional construct encompassing physical, mental and social facets of life. It is an accepted outcome parameter not only in international classification systems such as ICIDH and ICF, but as well in clinical guidelines and disease management programs. Measuring quality of life allows for comparison of different diseases though it certainly lacks disease specific aspects. Thus, it has to be assumed that in patients with distinct functional deficits QoL cannot cover all aspects that are important for the individual patient. This study focuses on laryngectomies and their self-evaluation of post-laryngectomy speech. It is well known that these patients experience a decreased QoL compared to patients after partial laryngectomy or healthy persons. In this study, the impact of voice restoration on the laryngectomies' QoL was evaluated. PATIENTS AND METHODS: In 20 male laryngectomies aged 62 +/- 8 years, relations between QoL and voice handicap were evaluated using two instruments as proposed in the international literature, i. e. the Short-Form Health Survey (SF-36) and the Voice Handicap Index (VHI). All patients had successfully been using tracheoesophageal substitute voice for at least one year. Complete data sets were available from all patients. Data were analysed using Microsoft Excel and Sigma Plot, Jandel Corp. software packages. RESULTS: Results of both the SF-36 and the VHI reveal wide interindividual ranges. There are statistically significant correlations (p < 0.05) between the SF-36's scales General Health and Vitality and the VHI, whereas no correlations were found between social and psychological scales and the voice handicap. DISCUSSION: Wide ranges of the data obtained reveal that obviously both health related quality of life and voice handicap are not affected in a group specific way. So, both tests are of clinical value to depict individual aspects of wellbeing after laryngectomy. The combination of VHI and SF-36 illuminates correlations between general and special subjective aspects. Strikingly, the laryngectomies' social and psychological status is not related to their voice handicap. Data allow for conclusion that laryngectomies' substitute voice problems do not affect social aspects of quality of life in a disease specific way, at least as long as voice restoration was successful at all.

Aged↗
PubMed2005

[Tactile-kinesthetic responsiveness in children with cleft lip palate].

BACKGROUND: Literature provides ample evidence that tactile-kinesthetic responsiveness is of basic importance for a normal speech development. The purpose of this study was to examine tactile-kinesthetic functions in children with cleft lip palate as they are suspected to be at risk to develop disturbances in this respect because of their anatomic defect. MATERIALS AND METHODS: Tactile-kinesthetic responsiveness was measured using the specific DEF-TK questionnaire as previously proposed by Kiese-Himmel. Twenty-seven children aged 1;3 to 7;11 years with cleft lip palate were examined. Forty-two children with an isolated speech development disorder served as age matched controls. RESULTS: The results of both the study and the control group did not differ on a statistically significant level (p > 0.05). Compared to the data taken from the test manual both groups exhibited a significant number of questionnaires which could not be analyzed because of too many unobservable (not missing!) items, yet, this number did not differ between the two groups. So a "best case" and a "worst case" were calculated but did not reveal significant differences either. CONCLUSION: Surprisingly and in contrast to the results reported in the literature the DEF-TK questionnaire exhibited methodical shortcomings with a significant number of cases in which it could not be analyzed due to too many unobservable items. So, the results obtained can only be discussed under reserve: They indicate that children with cleft lip palate do not exhibit more tactile-kinesthetic problems than children with an isolated speech development disorder and thus do not require specific therapy in this field.

Chi-Square Distribution↗
PubMed2004

[Speech impaired children. Anxiety, depression and quality of life of the mothers].

BACKGROUND: It is widely held that the well being of a mother significantly influences the way she brings up her child: Mothers with depression speak less to their child than healthy mothers do and so their emotional disorder has to be regarded an important cofactor for their child's speech development. On the other hand it is suspected that a mother's well being and quality of life may be influenced by her child especially in cases when the child suffers from impairment or developmental disturbance. As literature provides only little information on this topic the purpose of this study was to estimate both health related quality of life HRQOL and distinctive emotional reactions i.e. depression and anxiety in mothers of children with a speech developmental disorder. MATERIALS AND METHODS: 100 mothers (age 33.4+/-5.3 years, range: 22 to 47 years) of 100 preschool children (32 girls, 68 boys; age 4.2+/-1.5 years, range 1;3 to 7;7 years) with a speech impairment were investigated. Mothers of children with cochlear hearing loss, syndromes or other developmental disorders were excluded from the study. To estimate the prevalence of anxiety disorders and depression in the mothers the German version of the Hospital Anxiety and Depression Scale (HADS) was used. Data from 157 healthy women from the German test manual served as controls. HRQOL was assessed by the SF-36 questionnaire with age matched normal controls taken from the German test manual. Microsoft((R)) Excel and Matlab((R)) software packages were used for description, analysis, and evaluation. The differences in prevalence rates were tested by chi(2)-test and Wilcoxon's rank sum test. RESULTS: Assessed by the HADS-depression subscale 11% of the mothers of speech impaired children met criteria for depression compared to 2.5% in the control group. The prevalence in the study group was significantly higher ( p<0.01). The prevalence of anxiety disorders did not differ from normative data on a significant level ( p>5%). The SF-36 questionnaire revealed lower scores of most SF-36 subscales on different significance levels. The results of both tests correlated on a statistically significant level. CONCLUSIONS: Screening mothers of speech impaired children for a "soft" parameter like HRQOL and for epidemiologically relevant emotional disorders like depression and anxiety is of significant clinical interest. The SF-36 and the HADS are suitable tests. As the results of both tests are highly correlated for clinical purposes it seems reasonable to focus on depression and anxiety only. Up to now no data exist about how fathers of speech impaired children react emotionally, so this question has to be focused on in future. Although data allow no conclusion on whether the speech impairment is the reason or the consequence of a reduced HRQOL or an emotional disorder the results clearly indicate the necessity to take into account the mothers' well being when dealing with speech impaired children.

Adult↗
PubMed2004

[Voice handicap in patients with organic and functional dysphonia].

BACKGROUND: The goal of this study was to assess and compare voice handicap in patients with benign organic and functional dysphonia. PATIENTS AND METHODS: Voice handicap was assessed using a German version of the Voice Handicap Index. A total of 108 German speaking patients, 64 women and 44 men aged 45.3+/-15.1 years with benign organic ( n=69) or functional ( n=39) voice disorders completed the questionnaire immediately after clinical examination and without knowing their individual diagnosis. Fifty individuals without voice complaints and normal voice status, 28 women and 22 men aged 47.1+/-15.5 years, served as controls. RESULTS: Significant differences ( P<0.001) were found between all dysphonic patients and the control group. When comparing dysphonic patients according to their gender and diagnosis group (organic or functional) no significant differences were detected. CONCLUSION: It can no longer be assumed that patients with functional voice disorders over emphasize their disease. The data obtained in this study prove that there are no gender specific differences in the way a voice disorder is experienced. There are also no differences in the way patients with a different language background experience their voice handicap.

Adult↗
PubMed2003

[Social orientation of parents of children with cleft lip and palate].

BACKGROUND: Cleft lip and palate are the most common malformation in the orofacial region. The type and dimension of the cleft determine the functional limitations of respiration, swallowing, speech, articulation and hearing. In addition, cosmetic and communicative restrictions influence the cognitive, social and educational progress and the wellbeing of the children affected. Their parents face a difficult and lasting task: They have to cope with their child's handicap and the current standardised treatment procedures which start in early infancy. To guarantee optimum therapeutic success parents must be included as co-therapists. Therefore more information about parents' concerns and coping strategies are required. METHOD: To assess the strain put on parents of children with cleft lip and palate as well as the parents' coping strategies, a standardised questionnaire for the German-speaking parents was used during consultation in the out-patient clinic. RESULTS. In comparison with parents of children with other handicaps, the parents of children with cleft lip and palate feel less stressed out and adopt strategies of coping such as intensification of partnership, use of social support, as well as self-respect and fulfillment. Working mothers are less preoccupied and less at risk of being focussed on the handicapped child only. In comparison, the parents of children with Orofacial clefts focus less on the handicapped child in general than those parents whose children suffer from additional behavioural disorders. DISCUSSION: Though several functional, behavioural and psychological disorders may occur in children with cleft lip and palate their parents feel comparatively little stress. They do use a variety of coping strategies and tend to adopt a rather positive approach. Certainly, additional disorders of the child lead to more parental stress and likewise requiring more attention to the child which may even accentuate existing behavioural disorders. CONCLUSION: Parents of children with cleft lip and palate experience less stress in comparison with parents of children with other handicaps. Therapeutic efforts and regular check of the child's progress might support parents' coping strategies. Therapists should also ask for additional disorders such as behavioural disorders and initiate adequate support.

Adaptation, Psychological↗
PubMed2003

Vocal fold vibration irregularities caused by different types of laryngeal asymmetry.

The common symptom of hoarseness is regarded to be caused by (1) turbulences and air loss due to incomplete glottic closure and (2) irregular vibrations of the vocal folds. With real time resolution, the latter can only be observed using high-speed recording techniques (> or =2,000 images/s). In this paper an actual recording method is described, called high-speed glottography (HGG), which quantifies vibration irregularities. It combines imaging and image processing techniques with a functional endoscopy of the disordered voice and delivers motion curves separately for each vocal fold. They are fitted with a computer simulation in order to identify the underlying driving parameters of the vibration. A vocal fold is assumed to vibrate as a system of two coupled oscillators ("two-mass model"). From the model fit to bilateral motion curves, the subglottal pressure, muscular tension and oscillating masses of the vocal folds can be computed with reasonable accuracy. Besides normal voices, HGG has been applied to selected clinical cases of voice disorders. Two types of irregularities have been measured: there is a frequency difference either between left and right vocal folds (horizontal asymmetry) or on one side between the ventral and dorsal third (vertical asymmetry). By modeling, both categories of irregular motion curves can be explained in detail. It is presumed that laryngeal asymmetry (either in mass or tension) causes irregular vibrations.

Adult↗
PubMed2003

[Measurement and interpretation of irregular vocal cord fold vibrations].

BACKGROUND: Irregular vibrations of the vocal folds are regarded as a main reason for the common symptom of hoarseness. With real time resolution, they can only be observed using high speed recording techniques (up to 10,000 images/s). METHOD: During the last years, we have developed a recording device and image processing software dedicated to the extraction of vocal fold motion curves from the image series. Irregular vibrations can be understood by using Hirano's "body-cover-model": one vocal fold is assumed to act as a system of two coupled oscillators (the vocal muscle and the epithelium, coupled by the connective tissue of Reinke's space). RESULTS: By applying this biomechanical two-mass model and inversely solving Bernoulli's equation, the driving parameters of the vibration were computed from the high speed image series in selected cases. These parameters, like the subglottal pressure und the bilateral tension of the vocal muscle cannot, in general, be measured directly. DISCUSSION: From the model, it can be supposed that laryngeal asymmetry (either in mass or tension) is the primary reason causing irregularity. The consequence of asymmetry in the medio-lateral direction are different fundamental frequencies on each side, while asymmetry in the anterior-posterior direction leads to ap-mode vibrations.

Diagnosis, Computer-Assisted↗
PubMed2003

[Coping strategies in laryngectomy patients].

BACKGROUND: Over the last few years, paradigms for judging the results of treatment of tumor patients have shifted. In addition to characteristics such as the complete excision of the tumor and the duration of patient survival, restoring the quality of life has become an equally important aim. There is still a lack of systematic (and sufficient) research on coping strategies as a means of dealing with malignant tumors of the head and neck. PATIENTS AND METHOD: In a cross-sectional study, 25 laryngectomees, whose voices had been successfully restored with a Provox voice prosthesis,were examined for their coping strategies and the effects of the illness on their lives. The standardized Trier Scales of Coping Strategies and a custom-made questionnaire, which helped to structure the anamnesis of disease specific functional restrictions and the state of rehabilitation, were used as the means of inquiry. RESULTS: A high percentage of patients were content despite objective and subjective restrictions. Voice replacement was mainly experienced as unproblematic,with psychosocial restraints more commonly being felt in connection with pain and difficulties ingesting food. A correlation between the patients' evaluation of physical,psychological and social experiences and the coping strategies applied could not be verified. The way laryngectomees deal with their illness does not differ from the strategies of patients suffering from malignant or chronic diseases of other organ systems. CONCLUSION: The Trier Scales of Coping Strategies is a suitable means for determining the coping strategies of laryngectomees who have been successfully rehabilitated with the help of voice prostheses. The patients examined here did not apply different coping strategies from groups of patients with other severe illnesses. Obviously, the limitations on communication do not constitute a determining factor in coping with the disease. This finding is useful when planning psychological and social rehabilitation, e.g. by psychosomatic interventions.

Adaptation, Psychological↗
PubMed2003

[Guidelines and their practical application in congenital hearing loss].

BACKGROUND: Permanent congenital hearing loss in children does not only influence speech acquisition but also has a severe impact on the entire intellectual and psychological development, and thus social integration is handicapped. However, at least partial compensation can be achieved by complex rehabilitative measures. One of the first medical therapies in children with congenital hearing loss is to equip them with hearing aids. As part of quality management the purpose of this study is to discuss pedaudiological aspects and results of hearing - impaired children equipped with hearing aids against the background of guidelines from Germany and the US. METHODS: Data of 107 children equipped with hearing aids from 1997 to 1999 were analysed referring to the relevant German and US guideline. RESULTS: In 53 girls and 54 boys, 45% were suffering from at least severe, 45% from moderate and 10% from mild hearing loss. 93 children presented sensory hearing loss, 8 combined and 2 conductive hearing loss. 2 children had unilateral hearing loss, one a combined on one ear and a sensory hearing loss on the other and one child had a central auditory processing disorder. The age when the hearing loss was diagnosed depended on its grade and correlated with adverse environmental aspects. 34 children suffered from a syndrome or multiple handicaps, in these cases, the hearing loss was diagnosed at a later date than in children suffering from hearing loss only. In cases with near deafness audiological results with hearing aids were not sufficient; in these cases, cochlea implantation had to be discussed as an alternative measure. CONCLUSION: The data obtained from this study underline the need for universal hearing screening. Discussing the data against the relevant German and US guidelines clearly shows that German benchmarks are not as strict as the American ones. This has to be taken into account for further guideline development in Germany. As permanent hearing loss in children with syndromes and multiple handicaps and children with adverse environment is diagnosed at a later date than in other children public, measures have to be taken to improve this situation.

Adolescent↗