Zemliak T. Predicting the course of diseases caused by bilateral larynx mobility disorders and based on complex examination of the vocal apparatus state and electromyography

The dissertation deals with the problem of quality diagnostics improving, disease prognosis, determination of the disease severity and assigment of optimal treatment tactics for patients suffering bilateral vocal fold paresis and paralysis. The dissertation is based on complex clinical and instrumental examination of larynx nervous and muscular condition, vocal and respiratory functions of 130 patients suffering larynx paresis and paralysis and 15 practically healthy persons (control group). The most informative evidence for predicting the severe course of disease have been determined. It enables to find out the most objective ways of relevant surgery treatment tactics and phonopedic reabilitation for patients suffering larynx mobility disorders. They are: values of PIF indicators (PIF 22,14±1,41%; р<0,01) and PEF (PEF 31,36±2,31%; p<0,01) indicators differing from the standard values for more than 80% and 60% correspondigly; Jitter index > 0,8 (0,96±0,7; р<0,01) and in Shimmer index >5 (5,43±1,1; р<0,01); the average number of videolaryngostroboscopy points >10 (10,59±0,48; р<0,01); symptoms of deep brain structures irritation, increase of delta waves proportion >25% (to 28,15±2,33%; р<0,01) according to EEG; Maximum Phonation Time <2 seconds ; There have been developed some criteria for justified designation of the side for chordoarytenoidotomy application in case of surgery treatment, based on detection of asymmetrical manifestations of retention preservation and biolectrical activity features of TA and CT laryngeal muscles according to LEMG, as well as features of vibratory oscillation preservation and vocal cord muscular tone according to videolaryngostroboscopy. There have been investigated some objective features of biolectrical brain activity according to EEG, occuring in case of primery peripheral larynx mobility disorders. It enables to develop rehabilitation methods of treatment for the above mentioned group of patients, considering extralaryngeal changes, and deepen knowledge as for central regulation of larynx.