Tympanometry was analysed according to cleft type with respect to age in 239 cleft palate patients (57 with bilateral cleft lip and palate (BCLP)), 122 with unilateral cleft lip and palate (UCLP) and 60 with isolated cleft palate (ICP). The frequency of type B tympanograms was 46.5 per cent in the BCLP group, 50.6 per cent in the UCLP group and 58.3 per cent in the ICP group. Type A tympanograms were more frequently observed in older patients (median age 11 years) in comparison to type B (median age five years; p < 0.001) and type C (median age six years; p < 0.001). The total sample showed an age-related decrease in the frequency of type B tympanograms (rs = -0.3942; p < 0.001). The frequency of type A tympanograms increased significantly with age (rs = 0.4263; p < 0.001), whereas type C was not correlated with age. In the UCLP group, the frequency of type B tympanograms decreased with age (rs = -0.4430; p < 0.001), the decrease being faster than in the BCLP group (rs = -0.3186; p = 0.001) and the ICP group (rs = -0.3378; p < 0.0001)). Type B tympanograms had the highest correlation with a hearing loss of 21-40 dB at mean hearing level at speech frequencies (MHLSF) (rs = 0.4574; p < 0.001), a lower correlation with a hearing loss of 11-20 dB (rs = 0.2184; p = 0.02) and the lowest correlation with hearing loss above 40 dB. At the ages of one to three, the frequency of type B is higher in UCLP patients than in the BCLP and ICP groups, decreasing at seven to 12, increasing again at 13 to 15, and thereafter showing a continuous decrease. In the BCLP group, the frequency of type B increased significantly at the ages of four to six and then decreased continuously from seven to 18. In ICP patients, the changes in the frequency of type B with age are not significant until the age of 15; at the age of seven, it is higher than in the BCLP and ICP groups. The type C tympanogram is not typically found in cleft palate patients and its frequency is not correlated with age. It can be presumed that each type of cleft lip and palate, due to its characteristic conditions in the epipharynx, will favour a different mode of pathophysiological development of middle-ear disease.

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The aim of the research was to compare voice and speech in three groups of alaryngeal speakers: 1) patients using esophageal speech, 2) patients with electro-acoustical speech aids and 3) patients with voice prostheses. Acoustic analysis and pronunciation tests were used for the analysis. Acoustic analysis included fundamental frequency, maximum phonation time, jitter, shimmer and intensity. Pronunciation parameters were: phonetic block duration, number of syllables in a phonetic block, rate of speech, maximum number of syllables in a phonetic block and rate of articulation in a maximal phonetic block. Our results demonstrated the advantages of tracheoesophageal puncture with implantation of a voice prosthesis over the other two techniques of alaryngeal speech. Voice and pronunciation with voice prostheses were closer to normal in many parameters: fundamental frequency, maximum phonation time, jitter, shimmer, duration of a phonetic block, number of syllables in a phonetic block, rate of speech and rate of articulation in maximal phonetic block.

The aim of the investigation is to compare voice and speech quality in alaryngeal patients using esophageal speech (ESOP, eight subjects), electroacoustical speech aid (EACA, six subjects) and tracheoesophageal voice prosthesis (TEVP, three subjects). The subjects reading a short story were recorded in the sound-proof booth and the speech samples were acoustically analysed. Speech sound production was judged by 15 students of phonetics. The following variables were considered: (1) voice quality: fo, jitter, shimmer and harmonic-to-noise ratio, (2) speech sound production: number of recognized VCV syllables, and (3) temporal organization of speech: duration of the phonetic block, number of syllables in the phonetic block, rate of speech, rate of articulation and number of syllables in the longest phonetic block. The results showed that nearly normal air-stream source (lungs) in speech production of speakers with tracheoesophageal prosthesis significantly contributed to the speech timing and speech intelligibility of the alaryngeal speakers.

The aim of the present investigation was to evaluate the acoustic parameters, perceptual estimation, and self-estimation of voice before, 1 month after, and 6 years after surgical removal of a vocal fold polyp. Subjects were five male patients who came to the Phoniatric Clinic because of breathiness. For all patients, a polyp of one vocal fold was diagnosed. The operation was performed using cold instruments based on the principles of contemporary phonosurgery aiming maximally at preserving the phonatory bridge of the vocal fold. The subjects were recorded in a sound-proof booth three times: before surgery, 1 month post-, and 6 years post-operation. The patients read a short tale and they pronounced a sustained vowel /a/. The following variables were measured: clinical (the distance of the polyp from the anterior commissure, the width of the polyp base and the size of the polyp), and acoustic (F0, jitter, shimmer, harmonic-to-noise ratio, voice turbulence index, degree of voice breaks, and long-term average spectrum). Acoustic variables were measured using the program Praat, while the estimation of voice quality was completed using the GRBAS scale and self-estimation questionnaire of the voice quality, which were answered by the patients. The results showed significant improvement in the variables investigated and improved patients satisfaction with their vocal health after the surgery.