STUDY OF THE STATE OF ENT-ORGANS IN CHILDREN WITH ANOMALIES AND DEFORMATIONS OF DENTOALVEOLAR APPARATUS AND SPEECH DISORDERS

The relevance of research. When examining patients with dentoalveolar anomalies, children with speech disorders can often be observed. For orthodontists, it is important to diagnose the etiologic component of these disorders, namely, whether they are the cause of diseases of the ENT-organs and whether they are directly related to orthodontic pathology. In order to study the impact of the pathology of the ENT-organs on the formation of speech disorders, clinical and additional examination methods were carried out. In case of respiratory tract narrowing due to the deviated septum, hypertrophic or allergic rhinitis, adenoid vegetations, hypertrophy of the tonsils, speech pathology may be observed. Specified pathologies are subject to treatment before the logopedic and orthodontic correction. According to our clinical study in children of the main group and of the comparison group, the apparent pathology of the nose and oropharynx was not detected. Subjective and objective methods of hearing examination also did not reveal deviations from the norm. For a more detailed study of the condition of the upper respiratory tract, it is advisable to use computer tomography of the skull and magnetic resonance therapy of the head. The purpose of research is to eliminate the influence of otorhinolaryngologic pathologies on the formation of speech disorders. Materials and methods. We examined 124 patients. Patients were divided into two groups: control and comparison. The control group consisted of 82 patients with anomalies and deformations of dentognathic apparatus and speech disorders. The comparison group consisted of 42 patients without orthodontic pathology who applied to otolaryngologists for a diagnostic examination. The examination did not show the expressed pathology of ENT-organs in the presence of speech impairment and 5 children (aged from 6 to 12 years) with ENT pathology and speech impairment were not included in the main comparison groups. To make clinical and additional diagnosis such methods as rhinoscopy, pharyngoscopy, otoscopy were used. Results and discussion. During the rhinoscopy of all the examined patients of control and comparison groups, it was found: the nasal passages were free, the nasal shells were of the usual size, the nasal membrane was in the medial position, pathological contents in the nasal cavity were not detected. During pharyngoscopy, attention was mainly paid to the size of palatine tonsils. Thus, 62 children (50%) had the 1st and 2nd stage of development, 42 (33.87%) - 2nd stage and 20 (16.13%) - II-III degree. Adenoids (nasopharyngeal tonsil) of the 1st and 2nd degree were established in 86 children (69.35%), 28 children (22.58%) - second degree and 10 (8.06%) - II-III degree, but in all children of the main and comparison groups, nasal breathing function was not noted. In 124 subjects (100%), there was no adenoid type of facial skeleton. Conclusion. With the narrowing of the respiratory tract due to a curvature of the nasal septum, hypertrophic or allergic rhinitis, adenoid vegetation, hypertrophy of the palatine tonsils, speech impairments can be observed. The specified pathologies are subject to treatment before the logopedic and orthodontic correction. According to our clinical examination of children of the main group and the groups of comparison, evident pathology of the nose and oropharynx was not detected. Subjective and objective methods of hearing examination also did not reveal deviations from the norm. For a more detailed study of the condition of the upper respiratory tract, it is advisable to use computer tomography of the skull and magnetic resonance therapy of the head

ALGORITHM OF PATIENT’S TREATMENT WITH THE PRESENCE ANOMALIES OF BITE AND SPEECH DISORDERS

Relevance of research. Under complex correction of speech disorders in existing orthodontic pathology, it is important to establish the causative factor, because incorrect tongue articulation, infantile type of swallowing and other bad habits can be the cause of dental and maxillary pathologies and, at the same time, speech disorders. The cause-and-effect relationship between dentoalveolar and speech disorders has been proved. Anomalies and deformations of the dentoalveolar apparatus prevent the sounds from being pronounced normally, contribute to strengthening the habits of improper articulation and complicate logopedic correction. The problem of logopedic correction of sound pronunciation should be addressed comprehensively in collaboration with an orthodontist. The purpose of the research. To treat patients with anomalies of bite and speech disorders according to the proposed algorithm. Materials and methods. To achieve study objectives, 82 patients with severe orthodontic pathology and speech disorders, with normal hearing and intellect, were accepted for treatment. Clinical examination according to the generally accepted scheme, extraoral and intraoral photographs, anthropometry, myography, cephalometry, and logopedic diagnostics of all aspects of speech were conducted. After establishing the diagnosis, determining the treatment plan, orthodontic treatment was performed simultaneously with speech therapy correction. Results and discussion. The first step in the algorithm of successful treatment (correction) of speech disorders and dentoalveolar anomalies was the explanation of its necessity. The second stage of the algorithm was a clinical examination, which included medical history taking and objective methods of examination. The speech therapy part of the algorithm provided for speech therapy diagnosis of all aspects of speech: sound pronunciation, vocabulary, grammar, phonetics. Additional methods of examination were performed for the preparation of the plan, the choice of method and tactics of treatment: extraoral and intraoral photographs, anthropometry, myography, cephalometry, which is an integral part of the second stage of the treatment algorithm for patients with abnormalities and deformations of the dentoalveolar device in conjunction with correction of speech disorders. The third stage of the algorithm was direct orthodontic treatment and speech correction. The retention period is the final stage of the algorithm for treating patients with abnormalities and deformations of the dental apparatus in combination with the correction of speech disorders. Conclusion. The algorithm for treating patients with anomalies of bite and speech disorders consists of the following blocks: motivation, detailed diagnosis, treatment planning and tactics, the active period of orthodontic treatment simultaneously with speech correction and patient management in the retention period

6 Jahre Erfahrungen mit einem Arzneimittelberatungsdienst für Patienten

BACKGROUND AND PURPOSE: Many patients are inadequately informed about their drug therapy. There is thus a need for providing additional drug information to patients. The authors here report on a 6-year experience with a drug information service for patients. PATIENTS AND METHODS: The information service was available by telephone, e-mail or regular mail and was addressed initially to patients in Saxony and since 2005 to patients throughout Germany. Demographic and drug therapy data of the patients were registered and analyzed using a relational database. All enquiries to the information service between August 2001 and January 2007 were evaluated. RESULTS: 5,587 enquiries were registered. 61.4% of the persons calling were female and 33.8% male (sex was unknown in 4.8% by anonymous calls). The most frequent reasons for an enquiry were a general need for information about drugs and therapy (27.5%) and adverse drug reactions (24.7%). The drug group most frequently enquired about were cardiovascular drugs, accounting for 34.4%, followed by neuropsychiatric drugs (15.1%). CONCLUSION: The results of this analysis show an evident need for a drug information service for patients. This need is possibly caused by the shortage of time that physicians can devote to patients. An independent and competent drug information service may improve the quality of medical care and the satisfaction of the patients involved