Ahmed Geneid

Helsinki University Central Hospital | HUCH · Department of Otorhinolaryngology

Objectives: The COVID-19 pandemic has globally affected healthcare workers' (HCWs) health and wellbeing. Most studies on COVID-19 have focused on tertiary healthcare. The aim of this study was to increase the knowledge on the effects of the pandemic on working conditions in tertiary and primary healthcare. Material and methods: The comparative c...

Background: COVID-19 and other respiratory infections spread through aerosols produced in respiratory activities and in certain surgical procedures considered as aerosol-generating procedures (AGP). Due to manipulation of the upper airway mucosa, rhinosurgery has been considered a particular risk for spread of respiratory infections. Our aim was t...

Background Vocal-fold augmentation is a continuously developing treatment modality for glottic insufficiency. Patients with glottic insufficiency attend the phoniatrics clinics with increasing frequency. Glottic insufficiency may be due to vocal-fold paralysis, paresis, atrophy, sulcus vocalis, scarring, and vocal-fold deficiency after laryngeal su...

Background Caring for our patients while taking care of our own safety as well as theirs is a major concern during the current pandemic. Therefore, many societies developed guidance documents to educate clinicians about the required precautions. This study aims to assess personal protective equipment (PPE) usage, hand hygiene practice and infection...

COVID‐19 has highlighted the need for indoor risk‐reduction strategies. Our aim is to provide information about the virus dispersion and attempts to reduce the infection risk. Indoor transmission was studied simulating a dining situation in a restaurant. Aerosolized Phi6 viruses were detected with several methods. The aerosol dispersion was modeled...

Unlabelled: Velopharyngeal dimensions change as a child with cleft palate (CP) grows. The aim of this study was to assess if the decision for velopharyngeal insufficiency (VPI) surgery can be made by the age of 3 years among CP children with moderate-to-severe VPI. In addition, we sought to clarify if speech therapy before VPI surgery is beneficia...

Objectives: The COVID-19 pandemic has posed several risk factors to healthcare workers' (HCWs') emotional distress. The purpose of the study was to enhance understanding of the experiences and feelings of HCWs during the COVID-19 pandemic, with specific reference to infection prevention and control (IPC) practices and guidance, focusing on the qual...

Objectives Healthcare systems and healthcare workers have been under considerable strain during the COVID-19 pandemic in many countries. Our study aimed to assess the mental well-being of Finnish healthcare workers from two hospital districts with differing COVID-19 incidence rates (HUS, Hospital district of Helsinki and Uusimaa/Helsinki University...

Objectives: The COVID-19 pandemic has caused unseen pressure on healthcare systems in many countries, jeopardizing the mental well-being of healthcare workers. The authors aimed to assess the mental well-being of Finnish healthcare workers from 2 hospital districts (Helsinki University Hospital [HUS] and Social and Health Services in Kymenlaakso [...

SARS‐CoV‐2 has been detected both in air and on surfaces, but questions remain about the patient‐specific and environmental factors affecting virus transmission. Additionally, more detailed information on viral sampling of the air is needed. This prospective cohort study (N = 56) presents results from 258 air and 252 surface samples from the surrou...

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cell entry starts with membrane attachment and ends with spike (S) protein–catalyzed membrane fusion depending on two cleavage steps, namely, one usually by furin in producing cells and the second by TMPRSS2 on target cells. Endosomal cathepsins can carry out both. Using real-time three-d...

Objective: To compare speech symptoms of velopharyngeal insufficiency (VPI) and incidence of secondary speech surgery in 10-year-old Finnish children with unilateral cleft lip and palate (UCLP) following primary palatal surgery using 2 surgical methods. Design: Single center analysis within the Scandcleft multicenter randomized controlled trial...

The need for multidisciplinary and multiprofessional management of dysphagia is constantly increasing and creating a major challenge for healthcare professionals and society, especially in terms of professional expertise and human resources. The distribution of tasks among the dysphagia team members, which includes phoniatricians, otolaryngologists...

Our aim was to validate a Finnish version of the Eating Assessment Tool (F-EAT-10) for clinical use and to test its reliability and validity in a multicenter nationwide study. Normative data were acquired from 180 non-dysphagic participants (median age 57.0 years, 62.2% female). Dysphagia patients (n = 117, median age 69.7 years, 53.0% female) refe...

Objective: To assess whether aerosol generation occurs during otologic surgery, to define which instruments are aerosol generating, and to identify factors that enhance safety in protection against airborne pathogens, such as severe acute respiratory syndrome coronavirus 2. Study design: An observational prospective study on aerosol measurements...

Objectives: Given its rarity and the lack of clear clinical markers, amyotrophic lateral sclerosis (ALS) remains a diagnostic challenge. Because bulbar-onset ALS (buALS) presents with impaired speech or swallowing, patients are often primarily referred to an otolaryngologist (ORL) or phoniatrician. The objectives of this retrospective cohort study...

We examined the usefulness of dried spot blood and saliva samples in SARS-CoV-2 antibody analyses. We analyzed 1231 self-collected dried spot blood and saliva samples from healthcare workers. Participants filled in a questionnaire on their COVID-19 exposures, infections, and vaccinations. Anti-SARS-CoV-2 IgG, IgA, and IgM levels were determined fro...

SARS-CoV-2 cell entry starts with membrane attachment and ends with spike-protein (S) catalyzed membrane fusion depending on two cleavage steps, one usually by furin in producing cells and the second by TMPRSS2 on target cells. Endosomal cathepsins can carry out both. Using real-time 3D single virion tracking, we show fusion and genome penetration...

PurposeOropharyngeal dysphagia (OD) is a common phenomenon in otorhinolaryngology and phoniatrics. As both sub-disciplines have a strong tradition and clinical experience in endoscopic assessment of the upper aerodigestive tract, the implementation of fiberoptic endoscopic evaluation of swallowing (FEES) was an almost self-evident evolution. This r...

During the COVID-19 pandemic, healthcare workers (HCWs) have faced unprecedented workloads and personal health risks leading to mental disorders and surges in sickness absence. Previous work has shown that interindividual differences in psychological resilience might explain why only some individuals are vulnerable to these consequences. However, n...

Objective Coronavirus disease 2019 has highlighted the lack of knowledge on aerosol exposure during respiratory activity and aerosol-generating procedures. This study sought to determine the aerosol concentrations generated by coughing to better understand, and to set a standard for studying, aerosols generated in medical procedures. Methods Aeros...

Saliva is an alternative sample material to nasopharyngeal swab in SARS-CoV-2 diagnostics. We investigated possible aspects to improve the reliability of SARS-CoV-2 detection from saliva. Saliva was collected from asymptomatic healthy subjects ( n =133) and COVID-19 patients ( n =9). SARS-CoV-2 detection was performed with quantitative reverse-tran...

Objectives: To assess malignant transformation rate, non-sinonasal malignancies, and factors contributing to recurrence in patients treated for sinonasal inverted papilloma (SNIP). Study design: Retrospective study. Methods: We retrospectively reviewed medical records of all patients treated for SNIP (n = 296) between the years 1984-2014 at He...

OBJECTIVES Given its rarity and the lack of clear clinical markers, amyotrophic lateral sclerosis (ALS) remains a diagnostic challenge. Since bulbar-onset ALS (buALS) presents with impaired speech or swallowing, patients are often primarily referred to an otolaryngologist (ORL) or phoniatrician. We analyzed the role of such specialists in ALS diagn...

Objective COVID-19 spreads through aerosols produced in coughing, talking, exhalation, and also in some surgical procedures. Use of CO2 laser in laryngeal surgery has been observed to generate aerosols, however, other techniques, such cold dissection and microdebrider, have not been sufficiently investigated. We aimed to assess whether aerosol gene...

Background Intubation, laryngoscopy and extubation are considered highly aerosol-generating procedures, and additional safety protocols are used during COVID-19 pandemic in these procedures. However, previous studies are mainly experimental and have neither analyzed staff exposure to aerosol generation in the real-life operating room environment no...

Purpose Due to the coronavirus disease of 2019 (COVID-19), teachers during the pandemic have had to adapt to online teaching at short notice. This study aims to investigate the voice symptoms and their environmental risk factors as well as the work ability associated with distance teaching and to compare these with symptoms in previous contact teac...

SARS-CoV-2 has been detected both in air and on surfaces, but questions remain about the patient-specific and environmental factors affecting virus transmission to the environment. Additionally, more detailed information on viral findings in air is needed. This cross-sectional study presents results from 259 air and 252 surface samples from the sur...

SARS-CoV-2 has been detected both in air and on surfaces, but questions remain about the patient-specific and environmental factors affecting virus transmission to the environment. Additionally, more detailed information on viral findings in air is needed. This cross-sectional study presents results from 259 air and 252 surface samples from the sur...

Aim: The purpose of the study was to determine aerosol exposure generated by coughing in operation room environments to create a quantitative limit value for high risk aerosol generating medical procedures. Background: Coughing is known to produce a significant amount of aerosols and is thus commonly used as a best reference for high-risk aerosol-g...

Background Applying measures that prioritize staff safety, while protecting patient safety and care, represents a challenge during the current pandemic. Many documents of recommendations toward safe practice have been developed for this purpose. Objective To assess adjustments that have been undertaken by phoniatricians and otolaryngologists in th...

Objectives/Hypothesis Facial functional restoration is one of the main goals in face transplantation. We report the oromyofacial function outcomes of two bimaxillary face transplantation (FT) patients in Helsinki. Study design Outcome Study. Methods Two male patients, aged 34 and 59, had severe functional facial disabilities following self‐inflic...

Objectives: To evaluate the effectiveness of safety guidelines in the workplace, the authors analyzed the work-related exposure to SARS-CoV-2 and the source of COVID‑19 infections among healthcare workers (HCWs), together with the use of personal protective equipment (PPE). Material and methods: A cross-sectional prospective study was conducted...

Mmeeting with other health care workers outside the workplace could be an independent risk for a COVID-19 infection, especially if working with COVID-19 patients. In our sample, if the source of COVID-19 infection was non-patient, the infection was more likely to be from a colleague (p<0.001) and 42% of infections from a colleague occurred during l...

Objective: To analyse the work-related exposure to SARS-CoV-2 and trace the source of COVID-19 infections in tertiary hospitals healthcare workers in light of the used PPE and their ability to maintain social distances and follow governmental restrictions. Design: Cross-sectional study Setting: Tertiary hospitals in Uusimaa region, Finland Particip...

The COVID-19 is a global pandemic. Its rapid dissemination and serious course require a novel approach to healthcare practices. Severe disease progression is often associated with the development of the Acute Respiratory Distress Syndrome and may require some form of respiratory support, including endotracheal intubation, mechanical ventilation, an...

Background: The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services...

Purpose: The present study aimed at measuring the smoothed and non-smoothed cepstral peak prominence (CPPS and CPP) in teachers who considered themselves to have normal voice but some of them had laryngeal pathology. The changes of CPP, CPPS, sound pressure level (SPL) and perceptual ratings with different voice tasks were investigated and the infl...

Background Classical singing pedagogy uses many concepts which lack precise definition and whose acoustic and physiologic correlates are unclear. This study focuses on the concepts “head resonance” and “imposto.” In singing guidebooks, head resonance has been described as causing vibratory sensations on the face and head, auditively it has been des...

Background: Periodontal diseases are a major public health problem with a 70% prevalence in adults. This retrospective controlled study aimed at studying radiologic periodontal findings in chronic rhinosinusitis with nasal polyps (CRSwNP) and without nasal polyps (sNP). Methodology: Radiologic and patient record data of CRSsNP (n=66) and CRSwNP (n=...

UEP Position Statement relating to Phoniatric and Laryngological services during the COVID-19 pandemic. From the Union of the European Phoniatricians (UEP) contains a series of recommendations to Phoniatricians and ENTs who provide and/or run Voice, Swallowing, Speech and language or pediatric audiology services.

Objective. This study investigated the relationship between the acoustic measure smoothed ceps-tral peak prominence (CPPS), teacher's quality of life as measured by the voice activity and participation profile (VAPP), laryngeal signs and symptoms, voice related health problems and laryngoscopic findings in Finnish teachers. The relationship between...

Introduction: Maxillary advancement may affect speech in cleft patients. The aim of this study was to evaluate the effect of maxillary advancement on Finnish alveolar consonants /s/, /l/, and /r/ in cleft patients. Materials and methods: Fifty-nine Finnish-speaking nonsyndromic cleft patients, who had undergone Le Fort I or bimaxillary osteotomi...

Phoniatricians usually have the key role when dealing with a voice disorder, supported by logopedists/speech-language pathologists. Cooperation with other medical or non-medical disciplines may contribute when needed. Fundamentals, general goals and the structure of voice therapy are followed by a survey of specific methods and techniques. No matte...

The chapter reflects the main clinical manifestations of voice disorders, the wide diversity and multiple sociocultural interrelations of which contrast with a consistent systematic order of aetiological or symptomatic categories. Instead, the compilation follows prevailing purposes to provide a useful overview for application in everyday practice....

Basic information for diagnosis and differential diagnosis of voice disorders is drawn from medical history (the nature of the change in the sound of the voice, pitch, extent and loudness of voice, frequently reported hoarseness and its severity, any occurrence of episodes of voice loss, fatigability of voice) and auditory evaluation (mean speaking...

Objectives: The present study aimed to investigate whether there are differences between Arabic-speaking and Finnish-speaking listeners in the impressions of a speaker's personality as evoked by various intentional voice qualities. Study design: This is an experimental study. Methods: Samples (N = 55) were gathered from native Finnish-speaking...

In the production of voiced speech, glottal flow skewing refers to the tilting of the glottal flow pulses to the right, often characterized as a delay of the peak, compared to the glottal area. In the past four decades, several studies have addressed this phenomenon using modeling of voice production with analog circuits and computer simulations. H...

Purpose: Teachers are professional voice users, always at high risk of developing voice disorders due to high vocal demand and unfavorable environmental conditions. This study aimed at identifying possible correlations between teachers' voice symptoms and their perception of noise, the location of schools, as well as the location and conditions of...

Introduction: To diminish the risk of voice disorders in people who are highly dependent on their voices, such as teachers, vocal screening is important already at the beginning of such individuals' professional studies. A reliable, specified screening tool is needed. The Acoustic Voice Quality Index (AVQI) has been found to differentiate normal v...

Objective. This study investigated the relationship between the acoustic measure smoothed ceps-tral peak prominence (CPPS), teacher's quality of life as measured by the voice activity and participation profile (VAPP), laryngeal signs and symptoms, voice related health problems and laryngoscopic findings in Finnish teachers. The relationship between...

A multichannel dataset comprising high-speed videoendoscopy images, and electroglottography and free-field microphone signals, was used to investigate phonation onsets in vowel production. Use of the multichannel data enabled simultaneous analysis of the two main aspects of phonation, glottal area, extracted from the high-speed videoendoscopy image...

Objective: The aim of this study was to analyse the associations between the spirometry parameter changes in relation to laryngeal finding changes and self-reported voice and throat symptom changes among patients undergoing a histamine challenge test. Patients and methods: Thirty adult patients with a chronic cough underwent a histamine challeng...

Purpose After surgery of vocal folds, almost every patient will need some voice rest. It is common to recommend total silence for some days, followed by less restricted voice use for variable periods. By now, we do not know how voice rest affects the healing process or the current practise in Europe. Methods Members of the European Laryngological...

Glottal inverse filtering (GIF) refers to technology to estimate the source of voiced speech, the glottal flow, from speech signals. When a new GIF algorithm is proposed, its accuracy needs to be evaluated. However, the evaluation of GIF is problematic because the ground truth, the real glottal volume velocity signal generated by the vocal folds, c...

Objective: This study investigated the relationship between the acoustic measure smoothed cepstral peak prominence (CPPS), teacher's quality of life as measured by the voice activity and participation profile (VAPP), laryngeal signs and symptoms, voice related health problems and laryngoscopic findings in Finnish teachers. The relationship between...

Objectives: Water resistance voice therapy applies phonation into water through a tube. This study investigates how strenuous this therapy can be for the vocal folds in terms of impact stress (IS). It further examines whether it is possible to estimate the IS using the contact quotient (CQ) and maximum derivative from an electroglottogram (EGG)....

Introduction Maxillary advancement may affect speech in cleft patients. The aim of this study was to evaluate whether preoperative velopharyngeal (VP) function and cleft type can predict VP function after a Le Fort I maxillary osteotomy. Materials and methods One hundred consecutive nonsyndromic cleft patients (54 females, 64 males) who underwent...

Background Developmental language disorder (DLD, also called specific language impairment, SLI) is a common developmental disorder comprising the largest disability group in pre-school-aged children. Approximately 7% of the population is expected to have developmental language difficulties. However, the specific etiological factors leading to DLD a...

Objectives: This study aimed to explain the possible reason why classical singers seem to spread their nostrils and raise their cheeks before starting to sing. Study design: This is an experimental study. Methods: Five subjects (three classical singers, two nonsingers) were investigated with nasofiberoscopy holding their breath after inhalatio...

Purpose: Listening tests for emotion identification were conducted with 8-17-year-old children with hearing impairment (HI; N = 25) using cochlear implants, and their 12-year-old peers with normal hearing (N = 18). The study examined the impact of musical interests and acoustics of the stimuli on correct emotion identification. Method: The child...

Vocal fold augmentation by injection of autologous fascia has been used since the 1990s with excellent safety record in 500 operations done under general anaesthesia. It is safe from risks arising from allergic or other foreign body adverse reactions. Fascia provides long-term augmentation and remains stable 3-10 years after injection. Vocal fold a...

The objective of this study was to evaluate associations between the breathing sound spectra and glottal dimensions in exercise-induced vocal cord dysfunction (EIVCD) during a bicycle ergometry test. Nineteen subjects (mean age 21.8 years and range 13-39 years) with suspected EIVCD were studied. Vocal folds were continuously imaged with videolaryng...

High-speed videoendoscopy, glottal inverse filtering, and physical modeling can be used to obtain complementary information about speech production. In this study, the three methodologies are combined to pursue a better understanding of the relationship between the glottal air flow and glottal area. Simultaneously acquired high-speed video and glot...

Abstract Background Tinnitus, which can persist for many years, usually affects the quality of life. Tinnitus is challenging to manage with a variety of options including psychotherapy and pharmacological treatment. Intratympanic (IT) injections of steroids or lidocaine (LD) are two of the pharmacological treatment options used in the treatment of...