Background: The majority of research on the effects of cochlear implants has been on clinical evaluations of efficacy (hearing and speech skills, and auditory thresholds). But it's unclear how much clinical efficacy metrics (speech, hearing, and language tests) actually demonstrate how beneficial cochlear implants (CI) are in everyday circumstances.

Objective: this study aimd to assess the performance of a child's current CI with both subjective and functional outcomes measures. Also, we aimed to assess factors affecting these outcomes after CI.

 Patients and Methods: The study group included 45 cochlear implanted children, their chronological age range between 4 to 12 years. Children were divided according to their language age into three groups, group 1(G1) includes15 children with a language age of less than two years, group 2(G2) includes 15 children with a language age of two to less than four years, and Group 3(G3) includes 15 children with language age four to six years. Assessment was done in two sessions, one for phoniatric evaluation and another for audiological evaluation.

Results: CI enabled children to develop speech perception in a closed manner evidenced by the early speech perception (ESP) test with pattern perception being the easiest and monosyllabic words being the most difficult and the least to develop. Most children with CI were able to control their voice, to a lesser extent to use speech in meaningful use in social situations and to develop communication strategies in oral situations which were the least to develop, this was evident by Meaningful use of speech Scale. Children with CI were able to acquire language and their chronological age.

Conclusion: The cochlear implant is an effective rehabilitative tool for the treatment of prelingually deafened children and this was evident by our results. A hierarchal approach of speech assessment according to the language age of the child and selection of age-appropriate speech perception test is very important to assess cochlear implanted children Speech recognition had a high degree of variability. Early implantation age and increased duration of implant experience were the most important factors associated with good performance with CI, better speech perception, and better language outcomes.

Background: Cochlear implants made a great impact in the management of severe-to-profound hearing loss in both children and adults. Its greatest impact is in helping children born with a profound hearing loss and implanted early to attend mainstream education and using spoken language to communicate. However, the final outcome in pediatric implantation is not predictable as there are large numbers of factors which will affect the outcome of cochlear implantation. Studying these determinants increases the ability of clinicians to offer educated preoperative prognosis and might potentially allow for manipulation of variables in an attempt to achieve the best possible outcome.

Objective: The aim of this study was to assess the preoperative factors affecting the audiological, speech, and language outcomes achieved by the recipients of cochlear implants.

Methodology: A total of 39 children with severe-to-profound sensory neural hearing loss were implanted with cochlear implants. Children had received their implants before age of 5 years. Tests of receptive, expressive language quotient, aided cortical auditory-evoked potential using speech stimulus, aided free field audiometry, and aided speech reception thresholds were administered. Characteristics of the child and the family (age before implant and duration of implant use, cause of hearing loss, preimplant use of hearing aids and language therapy, and sociodemographic characteristics of their families) were the preoperative variables. These variables were considered predictors of audiological and language outcomes achieved by children and were determined using statistical analysis by univariate and multivariate analyses.

Results: Age of the studied children at time of cochlear implantation was statistically significant predictor for CI outcome as regard receptive language quotient and also for N1 latency. Hearing age of the studied children was a statistically significant predictor for CI outcome as regards P1 latency.

Conclusion:  Based on our findings, two most important factors affecting outcome of cochlear implantation were the age at implantation and the hearing age. Other factors were important but did not affect the outcome significantly.

Background: Adenoid hypertrophy alters the posture of the oro-facial structures by obstructing the upper airways and restricting nasal breathing. These postural changes may eventually have an impact on facial skeletal development and dental occlusion. The postural adjustments may negatively impact a child’s life by affecting a number of speech-production factors.

Objective: This study aimed to detect the speech sound disorders in school aged Egyptian children with adenoid hypertrophy and if they were related to structure changes in the airway that caused by adenoid hypertrophy.

Methods: 300 school-aged Egyptian children aged from (5–15) years old with speech sound disorders (SSD). They were divided into 2 groups; Group 1 consisted of 150 children with speech (SSD) and adenoid hypertrophy, and Group 2 consisted of 150 children complained from (SSD) without adenoid hypertrophy. All children were evaluated by protocol of language assessment and articulation test used in Assiut University Hospital.

Results: Speech sound disorders (SSD) mainly the omission and distortion are more frequent in (group 2) while, the sub­stitution errors are more prominent in (group 1). The interdental sigmatism was the most frequent speech sound disorder in (group 1) especially those with adenoid hypertrophy occupying more than 50% of the airway, whereas, devoicing, gliding and back to front are more frequent in (group 2).

Conclusions: Adenoid hypertrophy can affects only the /s/ sound production which needs precise placements of the articula­tors especially the tongue, and seems to be vulnerable due to the structural alteration of the oral cavity caused by adenoid hypertrophy.

Background: Persistent inflammation of the nose and sinuses for more than 3 months is known as chronic rhinosinusitis (CRS). Relation between CRS and voice problems had been considered, however studies that highlighted the existence of dysphonia in CRS patients or the effect of sinusitis on the individual voice and the larynx are sparse.

Objective: We aimed to detect the impacts of CRS on the laryngeal mucosa and voice quality among children (6-18 years old).

Methods: A total of 120 children aged (6-18) years old. They were divided into 2 groups: the controls (60 children) who are healthy, normal, and hadn't CRS, and the patient group (60 children) who met the CRS criteria. All children were evaluated by using the protocol of voice evaluation in Phoniatric Unit in Assiut university Hospital including auditory perceptual assessment of voice, flexible fiberoptic laryngoscope for visual assessment of the vocal tract and multidimensional voice profile for acoustic analysis.

Results: The most frequent presentations in CRS patient were chronic nasal obstruction and phonasthenic manifestations. There were statistically significant variations between both groups regarding auditory perceptual assessment, laryngeal findings and acoustic parameters. Additionally, there was a positive correlation between CRS severity and increasing grade of dysphonia.

Conclusions: CRS has impacts on auditory perception assessment of voice, laryngeal findings and some acoustic parameters such as fundamental frequency, soft phonation index and harmonic to noise ratio. Increasing severity of CRS correlated with progression of dysphonia. CRS is considered a risk element for development of dysphonia.

Background: Patients with orofacial cleft are at high risk for neurobehavioral problems including learning disability, impaired language function, psychosocial adjustment issues, and persistently reduced academic achievement. All these factors may be related to decrease intellectual abilities of those patients. The presence of velopharyngeal insufficiency (VPI) leads to affection of speech intelligibility due to atypical consonant productions, abnormal nasal resonance, nasal air emission, compensatory articulatory mechanism, and facial grimace.

Objective: This study aimed at assessing the cognitive functions of patients with (VPI) and their effect on speech intelligibility.

Methods: Fifty patients with (VPI) were selected from the Outpatient Clinic of the Phoniatric Unit in Assiut University Hospital. All patients were evaluated by protocol of nasality assessment including auditory perceptual assessment of speech, assessment of overall intelligibility of speech, nasoendoscopy, and psychometric evaluation.

Results: The mean intelligence quotient (IQ) of patients with VPI was 75.2±14.5 with a range between 41 and 107. The main defect was present in quantitative potential and then verbal ability followed by visual ability with memory having the highest mean. Patients with repaired cleft palate had the highest score (86.53±9.96), while the least score was reported among those with velopharyngeal disproportion (72.50± 9.59). There was a non-significant negative correlation between IQ degree and speech unintelligibility (p = 0.82).

Conclusion: About half of the patients with (VPI) have below average mentality. Patients with repaired cleft palate had the highest (IQ) score. Increased (IQ) score was accompanied by decreased speech unintelligibility, although it does not reach the level of significance.

Objective: Laryngopharyngeal reflux is a silent cause of laryngeal disorders which was documented in the last decade by many studies. This study aimed to evaluate the prevalence of laryngeal reflux in GERD cases and to evaluate the effect of GERD treatment on these laryngeal disorders.

Patients and Methods: In this single-arm (pre and post) quasi-experimental study, eighty patients with GERD were examined for laryngeal disorders by rigid laryngoscopy and assessed by the Reflux Finding Score (RFS). Complaints of patients were evaluated using the 9-item Reflux Symptom Index (RSI) questionnaire. Patients received medical treatment of GERD in the form of proton pump inhibitors (PPIs) only, and they were reassessed after 3 months for improvement in their symptoms and signs using RSI and RFS systems to compare patient complaints and findings in the laryngeal endoscopy pre- and post-treatment.

Results: Among 80 confirmed GERD cases, 70 (87.5%) suffered from laryngeal disorders. Throat clearing and postnasal drip were the most prevalent symptoms, and ventricular obliteration and erythema, vocal fold and diffuse laryngeal edema, and posterior commissure hypertrophy were the most detected signs. Significant improvement in both symptoms and signs after 3 months of PPI therapy was clearly observed. The resistance rate among our studied patients was reported to be 22.4%.

Conclusion: GERD can be considered as an inducer or cause of laryngeal disorders, with a significant direct proportional relationship between the severity of GERD and both the RSI and RFS. PPI greatly improves laryngeal disorders among GERD patients with a high response rate (77.6%).