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Publications (9)3 Total impact

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    ABSTRACT: Voice quality disorders - dysphonias are the significant problem from therapeutic, social and economic point of view. The routine therapy does not always bring spectacular effects. The important role play the innovative methods supporting therapy of voice quality disorders. PURPOSE: The aim of the study is to assess the effects of vibratory therapy of the larynx (Medical VR) in patients with hyperfunctional dysphonia and stimulating currents in phonatory exercises (VocaStim-Master) in paralytic dysphonia based on the analysis of parameters of objective assessment of voice quality. MATERIAL AND METHODS: Forty patients with hyperfunctional dysphonia treated routinely were included in the study. 20 patients apart from the routine therapy were additionally treated using the vibratory therapy of regions of the larynx (Medical VR, CyberBioMed LLC). In group of 40 patients with paralytic dysphonia, in 20 patients the adjuvant therapy by stimulating currents in phonatory exercises (VocaStim-Master, Physiomed) was used. The results of treatment and adjuvant therapy in hyperfunctional and paralytic dysphonia were analyzed based on: MPT, parameters of stroboscopic and acoustic evaluation (F(0), Jitter, Shimmer, NHR) and narrow-band spectrography. RESULTS AND CONCLUSIONS: : The analysis of the results indicated the usefulness of used parameters of objective assessment of voice quality taking into consideration the diagnostic and therapeutic aspect in hyperfunctional and paralytic dysphonia. Adjuvant vibratory therapy of the larynx in hyperfunctional dysphonia and stimulating currents in phonatory exercises in paralytic dysphonia improved the effectiveness of the therapy, what was confirmed by the analysis of parameters of objective assessment of voice quality.
    Otolaryngologia polska. The Polish otolaryngology 09/2012; 66(5):328-336.
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    ABSTRACT: Hyperfunctional dysphonia is the most frequent type of occupational functional dysphonia. Pharmacotherapy, physiotherapy and psychotherapy are used in the treatment of occupational dysphonia. Vibratory massages of the regions of the larynx relax the external muscles of neck, which have an indirect impact on the tension of the vocal folds. The aim of the study is to assess the impact of vibratory stimulation therapy on voice quality in patients with hyperfunctional occupational dysphonia treated pharmacologically. Forty patients with hyperfunctional occupational dysphonia treated phoniatrically in the Phoniatric Outpatient Clinic were included in the study. Patients were divided into two groups. Group I consisted of 20 patients treated pharmacologically. In group II, including 20 patients, apart from pharmacotherapy the vibratory stimulation therapy by the device of VR type (CyberBioMed LLC) was used. In the analysis of voice quality the evaluation of the vocal folds vibration using videolaryngostroboscopy and acoustic assessment of voice were conducted. The perceptual assessment of voice, the visualization of the vocal folds vibration in stroboscopic examination of the larynx and the acoustic assessment of voice enable the appropriate diagnostics of the clinical type and voice quality in hyperfunctional dysphonia. The tension of superficial and deep muscles of neck has the impact on the phonatory function of the larynx. Pharmacological treatment improves the voice quality in hyperfunctional occupational dysphonia. Pharmacological treatment combines with the relaxation of muscles of neck using the device of VR type significantly improve voice quality in hyperfunctional occupational dysphonia.
    Otolaryngologia polska. The Polish otolaryngology 05/2012; 66(3):219-26.
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    ABSTRACT: Voice quality disorders – dysphonias are the significant problem from therapeutic, social and economic point of view. The routine therapy does not always bring spectacular effects. The important role play the innovative methods supporting therapy of voice quality disorders.PurposeThe aim of the study is to assess the effects of vibratory therapy of the larynx (Medical VR) in patients with hyperfunctional dysphonia and stimulating currents in phonatory exercises (VocaStim–Master) in paralytic dysphonia based on the analysis of parameters of objective assessment of voice quality.Material and methodsForty patients with hyperfunctional dysphonia treated routinely were included in the study. 20 patients apart from the routine therapy were additionally treated using the vibratory therapy of regions of the larynx (Medical VR, CyberBioMed LLC). In group of 40 patients with paralytic dysphonia, in 20 patients the adjuvant therapy by stimulating currents in phonatory exercises (VocaStim–Master, Physiomed) was used. The results of treatment and adjuvant therapy in hyperfunctional and paralytic dysphonia were analyzed based on: MPT, parameters of stroboscopic and acoustic evaluation (F0, Jitter, Shimmer, NHR) and narrow-band spectrography.Results and conclusions: The analysis of the results indicated the usefulness of used parameters of objective assessment of voice quality taking into consideration the diagnostic and therapeutic aspect in hyperfunctional and paralytic dysphonia. Adjuvant vibratory therapy of the larynx in hyperfunctional dysphonia and stimulating currents in phonatory exercises in paralytic dysphonia improved the effectiveness of the therapy, what was confirmed by the analysis of parameters of objective assessment of voice quality.
    Otolaryngologia Polska. 01/2012; 66(5):328–336.
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    ABSTRACT: Vocal folds play a crucial role in voice production. The physiological vibrations of vocal folds depend on the unchanged multilayered structure of the vocal folds mucosa. Morphological changes of mucosa are the cause of voice quality disorders - dysphonia. The aim of this study was to determine the morphological base of dysphonia in patients with vocal folds atrophy. A group of 24 patients with larynx atrophy confirmed by endoscopic (VLS) and stroboscopic (VLSS) examination of the larynx was included in the study. The morphological assessment of the larynx mucosa was carried out with the use of the transmission electron microscopy (TEM). Ultramorphological examinations revealed changes in the epithelium, basal membrane and lamina propria of the vocal folds mucosa. An increased number of collagenous fibers, fibroblasts with signs of vacuolar degeneration inflammatory cells and a decreased number of blood vessels and pericytes were observed. Morphological changes found in the epithelium, basal membrane and lamina propria of the vocal folds mucosa were the cause of disorders of vocal folds vibrations registered in the stroboscopic examination of the larynx (VLSS).
    Folia Histochemica et Cytobiologica 01/2011; 49(4):659-63. · 1.10 Impact Factor
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    ABSTRACT: The high quality of a euphonic voice is the result of complex interactions between many organs and systems. Vibrating vocal folds play a crucial role in this process. Their physiological motion is conditioned by the presence of the layered structure of laryngeal mucosa. In this study, we assessed the degree of dysphonia according to the Union of European Phoniatrics (UEP) scale. Videoendoscopy (VLS) and videostroboscopic (VLSS) examination of the larynx was used to visualize the vibration of the vocal folds. Morphological assessment of the inter-membranous part of the vocal fold mucosa was carried out using material collected after surgical treatment (60%) or obtained from autopsy (40%). The samples were examined by light microscopy and transmission electron microscopy. In euphonic voices, 1° of dysphonia (UEP) and the physiological endoscopic (VLS) and stroboscopic (VLSS) findings of vocal folds were registered. No morphological or ultramorphological changes were observed in the cells of the multilayered flat epithelium, basal membrane or in the stroma. Unchanged epithelial cells were situated on the basal membrane with folds. Moreover, numerous pericytes, vessels with multiplication of basal membranes, scanty collagenous fibers, plasmatic cells and lymphocytes were seen. Morphological changes with signs of atrophy and polypoid degeneration of the vocal fold mucosa were found in only 3 (15%) patients.
    Folia Histochemica et Cytobiologica 01/2011; 49(1):72-9. · 1.10 Impact Factor
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    ABSTRACT: The aim of the study was to provide a morphological assessment of the laryngeal mucosa in patients with hyperfunctional dysphonia diagnosed by psychoacoustic and videostroboscopic methods. Forty patients with voice quality disorders of hyperfunctional dysphonia were recruited for participation in the study. The diagnosis of dysphonia was based on the Voice Rating Scale GRBAS, and endoscopic and stroboscopic assessment of the vocal folds. Acoustic assessment was carried out using following parameters: fundamental frequency, Jitter, Shimmer, Noise to Harmonic Rate and Yanagihara (YG) scale. In order to evaluate the morphology of the vocal fold mucosa transmission electron microscopy was performed using postoperative material obtained from the larynx. Results of clinical and morphological analysis were compared with the reference group. The morphological material was obtained from patients with hypopharyngeal cancer without pathological changes of the vocal folds. The psychoacoustic assessment using the perceptual GRBAS scale enables the appropriate diagnostics of hyperfunctional dysphonia, which was confirmed by evaluation of acoustic parameters and YG scale analysis. In 40 patients with voice quality disorders causing by hyperfunctional dysphonia, in morphological assessment of the laryngeal mucosa, 4 (10%) patients demonstrated the presence of oedema and signs of intensive dysphonia in psychoacoustic and stroboscopic examination. Oedema of the laryngeal mucosa confirmed by stroboscopic and ultramorphological examination may coexist with hyperfunctional dysphonia. The presence of the laryngeal oedema in patients with hyperfunctional dysphonia has the negative impact on voice quality in psychoacoustic assessment with the use of the GRBAS and YG scales.
    Advances in Medical Sciences 01/2011; 56(2):343-51. · 0.80 Impact Factor
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    ABSTRACT: Disorders of voice quality are mostly influenced by organic changes in larynx. In the assessment of ultrastructure of vocal fold mucosa the most useful is the technique of transmission electron microscopy (TEM). The organic dysphonia is diagnosed by the perceptual, endoscopic (VLS) and stroboscopic (VLSS) assessment of larynx and acoustic assessment. The aim of the study was to determine morphological changes and voice quality disorders in patients with edema of larynx. 40 patients with vocal folds edema (I group) and 10 patients with no pathological changes of larynx (II group) were included in the study. The morphological assessment of vocal folds mucosa was carried out with the usage of transmission electron microscopy (TEM). The voice quality was examined by the subjective and objective methods. The endoscopic and stroboscopic (VLS and VLSS) examination of larynx and acoustic analysis of voice were carried out. Morphological changes of vocal folds mucosa were observed. Epithelial cells showed features of vacuolar degeneration. Moreover enlargement of intercellular spaces, small rugosity of basal membrane and inflammatory infiltration of stroma, a large number of blood vessels and a cumulation of elastic and collagenous fibers were observed. Stillness of vocal folds influenced disorders of voice quality with features of dysphonia. The endoscopic and stroboscopic examination of larynx clinically shows the morphological changes of vocal folds mucosa. Simple and non-invasive acoustic examination of voice in patients with edema of larynx objectively confirms the subjectively registered dysphonia.
    Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 09/2010; 29(171):181-6.
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    ABSTRACT: Cochlear Implant (CI) is the most advanced technical solution in the treatment of profound hearing loss and deafness in patients of all age groups. The aim of the study was to analyse the speech and linguistic disorders in adults with pre- and postlingual deafness rehabilitated with Cochlear implant (CI). MATERIAL AND METHODS: 21 adults with pre- (I group) and postlingual (II group) deafness deriving no benefit from hearing aids participated in this study. Phonatory organ was examined by endoscopy (VLS) and stroboscopy (VLSS). Test of Auditory Perception (TSS) was conducted directly after the activation of speech processor and after rehabilitation. The logopedic assessment before and after CI was based on the examination of motoric activity of articulatory organs, type of respiration, loudness of speech and the assessment of articulation. The linguistic assessment of grammatical and lexical aspect was carried out. The prosodic elements of speech were also analysed. RESULTS: Stroboscopic examination pointed to hypofunction of larynx in patients with prelingual deafness and hyperfunction--in postlingual deafness. The values of TSS were improved after CI, especially in patients with postlingual deafness. The most severe disorders of the efficiency of articulatory organs were observed in patients with prelingual deafness before CI. In the group of prelingually deaf patients disorders of the articulation of vowels and consonants as well as the lexical and grammatical aspect of speech were improved after CI. The correctness of syntax and inflection, development of active vocabulary, improvement of prosodic elements of speech were noticed in patients with postlingual deafness after CI. CONCLUSIONS. Patients with postlingual deafness achieved better results of rehabilitation in auditory perception than prelingually deaf patients. The linguistic improvement of grammatical and lexical aspect was noticed especially in prelingually deaf patients after implantation. This group of patients achieved also the significant progress in prosodic elements of speech in comparison with the results before implantation.
    Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 09/2010; 29(171):187-93.
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    ABSTRACT: The aim of the rehabilitation in laryngectomized patients is to produce phonatory communication. It is important to choose the optimal method of rehabilitation. Most of the patients use the oesophageal or pharyngeal speech as an effect of natural rehabilitation with vocalistic method. Another group of larygectomized patients is rehabilitated with surgical method which leads to shunt speech. THE AIM OF STUDY was to compare the quality of oesophageal and shunt speech with euphonic voice to choose the optimal method of rehabilitation in laryngectomized patients. The quality of vicarious phonation was examined in 30 patients with shunt speech and in 20 patients with oesophageal speech. Examination results of the subjective, objective and acoustic assessment were compared with values registered in physiological (euphonic) speech. The results of objective assessment were statistically analysed. The shunt and oesophageal speech enabled effective verbal communication of laryngectomized patients. The parameters of clinical subjective and objective assessment of shunt speech pointed to its high quality which is similar to physiological phonation. The acoustic analysis of voice confirmed the results of subjective and objective assessment of quality of shunt voice and speech in laryngectomized patients. In conclusion, the surgical rehabilitation of voice after total laryngectomy gave patients the great opportunity for a remarkable improvement in vicarious phonation.
    Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 04/2010; 28(166):277-83.