Treatments & Therapies

Phoniatrics – Treatment, Effects & Risks


Phoniatrics is a separate medical specialty that was part of ear , nose and throat medicine (ENT) until 1993. Phoniatrics deals with the topics of hearing, voice and speech disorders as well as swallowing difficulties and has strong interdisciplinary features.

Together with pediatric audiology , which primarily deals with problems in children’s voice and language development and auditory perception, phoniatrics has established an independent medical specialty in Germany and Europe.

What is phoniatrics?

The medical specialty of phoniatrics is centered around hearing problems, voice and speech disorders, and swallowing disorders . Phoniatrics is strongly interdisciplinary, because it is not only about medical-physiological problems, but also non-medical problems. That is why other medical and non-medical specialties such as neurology , psychiatry , geriatrics , orthodontics , speech therapy and a few others are also included.

In Germany, phoniatrics, together with pediatric audiology, which deals with the corresponding childhood development and perception disorders , forms an independent specialist medical orientation that was renamed in 2004 from a specialist in phoniatrics and pediatric audiology to a specialist in speech, voice and hearing disorders in children.

The specialist medical training includes a 2-year basic training in the field of ear, nose and throat medicine and a 3-year specialist training in the fields of voice and speech disorders and the field of hearing disorders in children. The origins of the medical specialty of phoniatrics go back to Hermann Gutzmann senior. back, who used the topic of speech disorders in his habilitation thesis in 1905.

Treatments & Therapies

Diseases and symptoms that can be diagnosed and treated in phoniatrics are typically related to voice, speech and fluency disorders ( stuttering ) or to swallowing or hearing problems. It does not matter whether the problems are of medical-physiological origin, e.g. B. due to an injury, surgery or illness or whether the problems are based on socio-psychological conditions.

This also illustrates the holistic, interdisciplinary approach of phoniatrics, which can also be seen in the treatment of voice disorders that can occur due to organic causes or are functional, such as overload or, in rare cases, the effects of shock. Speech and language disorders ( dysarthria and aphasia ) in adults can occur as a result of voice disorders, but are usually based on neurological problems due to the loss of certain areas of the brain after a stroke or due to a brain tumor . Disorders of the flow of speech such as stuttering are also a clinical picture that falls within the treatment spectrum of phoniatrics.

The swallowing process, which is also the subject of phoniatrics, involves the ingestion, crushing and movement of solid or liquid food and saliva from the mouth to the stomach, with movement through the esophagus being involuntary by corresponding peristaltic movements of the esophagus. In addition to organic problems, there are a number of reasons why swallowing disorders (dysphagia) can occur and require careful diagnosis and therapy.

Hearing disorders in adulthood can also have a variety of other causes, in addition to organic changes caused by injury, surgery or age, and therefore also fall within the treatment spectrum of phoniatrics. A special treatment area with great challenges is voice reassignment in gender reassignment , in order to adapt the voice of the transformed woman or man to their new gender as a woman or man.

Diagnosis & examination methods

Hearing disorders in adults usually manifest themselves symptomatically as hearing loss . The causes can be very diverse and cover a wide spectrum, ranging from simple blockage of the outer auditory canal by earwax , ossification in the middle ear or damage to the eardrum to the conversion of sound into nerve impulses in the inner ear or problems with the further processing of nerve impulses in the brain. In addition to the ear examination ( otoscopy ), several subjective and objective audiometric procedures are available for the diagnosis, with which the causes of the hearing problems can be localized.

If there is a suspicion of a voice disorder and a careful anamnesis, in order to be able to exclude certain causes for the possible voice disorder from the preconditions and the course of the complaints. Further diagnostic procedures such as electromyography (EMG) of the larynx muscles and/or electroglottography can follow in order to identify or rule out organic problems. Electroglottography is a non-invasive procedure that records the function of the two vocal folds , i.e. their vibration cycle, in an electroglottogram and allows conclusions to be drawn about the functionality of both vocal folds.

Other diagnoses such as magnetic resonance imaging from the head to the upper chest can provide conclusions about possible infections and the integrity of the laryngeal nerve . Depending on the diagnosis, therapy options include logopedic treatments, which can also be supplemented by logopedic therapy devices that the patient can use at home with ongoing success monitoring. In some cases, there are also various surgical treatment methods (phonosurgery) to choose from. In the case of spasmodic dysphonia, in which the vocal folds largely lose their function due to muscle spasms, botulinum toxin injections can be usedin the larynx provide relief, at least for a while.

For voice and speech disorders without recognizable organic causes, there are a number of logopedic voice therapies that involve voice production, breathing , articulation and the patient’s personality. In many cases, electrical stimulation therapy in the area of ​​the larynx can accompany the therapy and promote or shorten the success of the treatment. In the case of existing swallowing difficulties, the fiber endoscopic swallowing examination (FEES) is often used as a diagnostic procedure to examine the swallowing process with flexible optics through the noseis introduced to be able to judge visually. Therapy options include logopedic swallowing therapy or, if localized organic damage is present, appropriate surgical measures.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.