magistrsko delo
Kaja Polajžar (Avtor), Irena Hočevar-Boltežar (Mentor)

Povzetek

Parezo glasilk najpogosteje povzroči okvara oživčenja, kot posledica poškodbe centralnega ali perifernega živčnega sistema. Unilateralna ali bilateralna pareza oz. paraliza rekurentnega grlnega živca je najpogostejši vzrok za zmanjšano ali popolno negibljivost ene ali obeh glasilk, kar vpliva na pomembne funkcije, kot so dihanje, požiranje in govor. V magistrskem delu sem raziskovala, kako motena gibljivost glasilk vpliva na funkcije grla, ter kakšno vlogo ima pri tem logopedska obravnava. V delu sem predstavila strukture, ki sodelujejo pri govoru, anatomijo in inervacijo grla, etiologijo in klinično sliko pareze zgornjega in rekurentnega laringealnega živca. Prav tako sem opisala diagnostiko ter možnosti zdravljenja oziroma rehabilitacije slabše gibljivosti glasilke, pri čemer sem se osredotočila predvsem na logopedsko terapijo. Empirični del predstavlja raziskava, v kateri sem anketirala paciente z unilateralno parezo oz. paralizo glasilk, ki so bili zaradi omenjene motnje prvič obravnavani na Kliniki za otorinolaringologijo in cervikofacialno kirurgijo (Center za motnje glasu in govora) v letu 2013. Pacienti so rešili anketni vprašalnik, ki je vseboval skrajšano verzijo v slovenščino prevedenega vprašalnika »Voice Handicap Index« (VHI 10) ter vprašanja o težavah s požiranjem in dihanjem. Pridobljene podatke sem primerjala s kontrolno skupino zdravih prostovoljcev primerljive starosti. Informacije sem prav tako pridobila z analiziranjem medicinske dokumentacije pacientov, ki so mi vpogled dovolili. Z raziskavo sem želela ugotoviti, ali se vzroki za pojav motene gibljivosti glasilke v Sloveniji razlikujejo od podatkov za druge države in ali obstaja povezava med načinom zdravljenja ter kliničnim stanjem pacientov po enoletnem zdravljenju. Zanimalo me je predvsem, ali obstajajo razlike v oviranosti zaradi glasovnih težav, težav pri požiranju in dihanju vsaj eno leto po nastanku motnje med pacienti, ki so obiskovali logopedsko terapijo, in tistimi, ki te obravnave niso imeli. Raziskava je pokazala, da je pri večini pacientov etiologija nastanka negibljive glasilke neznana, sledi pa ji ob tiroidektomiji nastala okvara rekurentnega laringealnega živca kot vzrok nastanka težav. Ugotovila sem, da pacientom predstavljajo največjo oviranost glasovne težave, šele nato težave s požiranjem in dihanjem. Raziskava je pokazala, da se je brez zdravljenja stanje funkcionalno izboljšalo le pri 23 % anketiranih pacientov Zaradi pomanjkanja izvajanja logopedskih obravnav nisem prišla do zanesljivih ugotovitev, ali se pri pacientih, ki obiskujejo logopedsko obravnavo, simptomi hitreje izboljšujejo kot pri bolnikih brez pomoči. Pri pacientih, ki so logopedsko obravnavo imeli, je le-ta temeljila na izvajanju manualne manipulacije. Ugotovila sem tudi, da je najpogostejša dolgotrajna glasovna težava pri bolnikih s paretično ali paralitično glasilko glasovna utrudljivost. Raziskava je prav tako pokazala, da težave s požiranjem in dihanjem pri pacientih z enostransko negibljivo glasilko vendarle niso redke in skupaj z moteno gibljivostjo glasilk vplivajo na kakovost življenja in dela pacientov.

Ključne besede

grlo;moteno delovanje laringealnih živcev;pareza glasilke;paraliza glasilke;logopedska obravnava;

Podatki

Jezik: Slovenski jezik
Leto izida:
Tipologija: 2.09 - Magistrsko delo
Organizacija: UL PEF - Pedagoška fakulteta
Založnik: [K. Polajžar]
UDK: 616.22(043.2)
COBISS: 11137353 Povezava se bo odprla v novem oknu
Št. ogledov: 564
Št. prenosov: 103
Ocena: 0 (0 glasov)
Metapodatki: JSON JSON-RDF JSON-LD TURTLE N-TRIPLES XML RDFA MICRODATA DC-XML DC-RDF RDF

Ostali podatki

Sekundarni jezik: Angleški jezik
Sekundarni naslov: The impact of disordered vocal folds' mobility on laryngeal functions
Sekundarni povzetek: The vocal fold paresis is most often caused by damaged nerves, a consequence of a trauma to the central or peripheral nervous system. Unilateral or bilateral paresis or paralysis of the recurrent laryngeal nerve are the most frequent causes of a partial or complete loss of flexibility of either one or both of the vocal cords, thus affecting vital functions such as breathing, swallowing and speech. In my master's thesis I have researched the effects of limited vocal cord flexibility on the functions of throat and the role speech therapy plays in the whole matter. In my thesis I have specified the structures present at the point of speech formation, the anatomy and innervation of the throat, aetiology and a clinical image of paresis of the superior and recurrent laryngeal nerves. I have also described the diagnostics and available treatment options, in other terms the rehabilitation of the dysfunctional flexibility of vocal cords, whilst mostly focusing on treatment involving speech therapy. The empirical part of my research consists of a survey conducted with the patients suffering from unilateral paresis or paralysis of the vocal cords, who were in the year 2013 initially examined at the Department of Otorhinolaryngology and Cervicofacial Surgery (Center for vocal disorders and speech impediment) as the result of the described disorder. Patients filled in a survey questionnaire, which comprised of a shortened translated version of the »Voice Handicap Index« questionnaire - » Voice Handicap Index -10« (VHI 10), along with questions regarding their experience with swallowing and breathing. I have then compared the acquired data with results obtained from a control group consisting of healthy volunteers of similar age. I have also gathered information by analysing medical documentation of the patients, who have granted me access to their medical records. The purpose of the research was establishing if the causes of vocal cord paresis are significantly different in Slovenia in comparison with other countries and also finding out a potential connection between treatment process and the clinical condition of the patients following a year long treatment. I was primarily interested in finding any variations of the level of sensory disability due to vocal disorders and issues with swallowing and breathing, after at least a year has passed since the issue first appeared, and comparing the patients who took part in speech therapy to those who have not. The research indicates the majority of patients' aetiology in regards to dysfunctional vocal cords remains unknown and is followed by the recurrent laryngeal nerve disorder resulting from thyroidectomy and presenting the cause for the appearance of this issue. I have found the patients' biggest handicaps were those related to vocal functions, followed by issues with swallowing and breathing. The research has shown that only 23 % of the patients taking part in the survey have experienced a functionality improvement without receiving any treatment. Due to an insufficient speech therapy implementation, I was unable to establish whether the patients taking part in the speech therapy treatment, experience a faster improvement of the symptoms compared to those not being treated at all. For patients participating in speech therapy, treatment was based on performing manual manipulation. I have also come to the conclusion, that the most common long-term vocal disorder with patients suffering from paresis or paralysis of the vocal cords, is vocal fatigue. The research also pointed out the issues patients suffering from unilateral vocal cord immobility have with swallowing and breathing aren't rare and along with the dysfunction of vocal cords, largely affect the quality of patients' lives and their work.
Sekundarne ključne besede: speech defect;govorna motnja;
Vrsta datoteke: application/pdf
Vrsta dela (COBISS): Magistrsko delo/naloga
Komentar na gradivo: Univ. v Ljubljani, Pedagoška fak., Logopedija in surdopedagogika
Strani: 121 f.
ID: 9166517