Phoniatrics
The Phoniatrie (Greek: "vocal healing" of phone , voice, and iatros , doctor) is a medical discipline that with disorders which voice , of speech , of language and swallowing is diagnostic , therapeutic and scientific busy. The discipline was introduced as an academic subject in Berlin in 1905 by the internist Hermann Gutzmann senior. (1865–1922) founded.
Phoniatrics, together with pediatric audiology, is a medical specialty that is based on the pathophysiology of communication and is responsible for diseases and disorders of language, voice , swallowing and children's hearing disorders. The subject is based on the anatomical - physiological , diagnostic and therapeutic principles of various specialist areas, including ENT medicine (otorhinolaryngology), and has close ties to other medical specialties, e.g. B. Neurology , Psychiatry , Pediatrics , Geriatrics ,Dentistry , oral and maxillofacial surgery , rehabilitation medicine and non-medical specialties e.g. B. Hearing aid acoustics, special education , psychology and acoustics .
history
The internist Adolf Kussmaul wrote the first comprehensive publication on language disorders in 1877. 1905, the year of Hermann Gutzmann senior's habilitation . on the subject of speech disorders as a subject of clinical teaching , is considered to be the founding year of the department, the name of which "Phoniatry" was introduced in 1920 by Miloslav Seemann and Hugo Stern. Especially Gutzmann sen. and his Viennese student Emil Fröschels have given significant impetus to the establishment of the field in medicine. Students of the two were soon active across Europe. The interdisciplinary nature of the two Phoniater also resulted in the creation of associated subjects as those of the speech therapy and the voice Heilpädagogik . Some of the students emigrated to the USA during the Nazi era and continued their clinical and teaching activities there, where the subject was not able to establish itself as it did in Europe. The academic training of the "Speech and Language Pathologists", who dominate in the USA, is not a medical one, but is housed in the philosophical faculties. Phoniater are now active worldwide, with a focus on Europe.
In Germany, phoniatry became a branch of ear, nose and throat medicine together with pediatric audiology in 1978, and in 1993 the independent subject of phoniatrics and pediatric audiology was created .
As part of the EU harmonization of further medical training, a Europe-wide harmonization of further training in the field of phoniatrics and pediatric audiology is being drafted within the professional societies.
The situation in Germany
The specialist in phoniatrics and pediatric audiology (Germany)
In order for a completed medical studies as a specialist of Phoniatrics and Pediatric Audiology to act (temporarily 2004-2018 "specialist in speech, voice and infant hearing disorders"), it requires a five-year training period.
At the time of the sub-area you had to be an ENT specialist with 4 years of further training in order to be trained in the sub-area for 2 more years. After the introduction of the specialist in 1992, these doctors were also allowed to use the independent specialist title on application to their medical association due to a transitional arrangement. The training period was set at 5 years in 1992, uniformly for all specialist areas, comprised 2 years of joint basic training with the ENT doctors and 3 years of specialist training. The background to this division was a decided merging of some subjects with specialist names under one, common roof, here as the field of ear, nose and throat medicine with specialists for ENT and specialists for voice, language and children's hearing disorders. By resolution of the German Medical Association 2018, the introduced German-speaking specialist designation, which never really caught on, was reversed and the common field of ENT was dissolved. Since then, an independent specialist has been anchored in the training regulations.
Treatment guidelines
The following guidelines in the field of phoniatry have so far been drawn up under the leadership of the DGPP :
- S2k guideline language development disorders in children of the DGPP . In: AWMF online (as of December 16, 2011) (in revision)
- S1 guideline for voice disorders of the DGPP . In: AWMF online (as of 01/01/2011) (will be newly developed as S2k guideline)
- S1 guideline communication disorders in neurogenic speech and voice disorders in adulthood, functional diagnostics and therapy of DGPP . In: AWMF online (as of September 18, 2014)
The previous, individual guidelines
- S1- guideline clutter of the DGPP . In: AWMF online
- S1 guideline stuttering of the DGPP . In: AWMF online
became a common guideline S3 guideline speech flow disorders of the DGPP . In: AWMF online (as of August 31, 2016) summarized.
Work in progress:
- S2k guidelines for language development disorders in children, therapy of DGPP . In: AWMF online (as of: registered)
- S3 guideline for oropharyngeal dysphagia due to head and neck cancer - diagnosis and therapy of DGPP . In: AWMF online (as of: registered)
We collaborated on the following guidelines:
- S2k guideline on one-sided cleft lip and palate of the German Society for Oral and Maxillofacial Surgery (DGMKG). In: AWMF online (as of July 1st, 2010) (in revision)
- S1 guideline aftercare of children, adolescents and young adults with cancer - Recognizing, avoiding and treating long-term consequences of the Society for Pediatric Oncology and Hematology (GPOH). In: AWMF online (as of June 1st, 2013) (in revision)
- S2k guideline hypersalivation of the German Society for Ear, Nose and Throat Medicine, Head and Neck Surgery e. V .. In: AWMF online (as of September 16, 2018)
- due to Revising mom. offline (as of 01/2019): S1 guidelines for neurogenic dysphagia of the German Society for Neurology (DGN). In: AWMF online (as of September 30, 2012)
- S2k guidelines for Fabry disease, diagnosis and therapy of the German Society for Neurology (DGN). In: AWMF online (as of June 30, 2013) (in revision)
- S2k guidelines for Down syndrome of the German Society for Child and Adolescent Medicine eV (DGKJ). In: AWMF online (as of July 31, 2016)
- S1 guideline aftercare of children, adolescents and young adults with cancer - Recognizing, avoiding and treating long-term consequences of the Society for Pediatric Oncology and Hematology (GPOH). In: AWMF online (as of June 1st, 2013) (in revision)
- S2k guideline General principles of medical assessment of the German Society for Neuroscientific Assessment eV. In: AWMF online (as of December 31, 2012) (in revision)
as well as participation in the following, registered guideline:
- S3- Laryngeal Cancer Guideline : Diagnosis, Therapy and Follow-up Care of the German Society for Ear, Nose and Throat Medicine, Head and Neck Surgery e. V .. In: AWMF online (Status: registered)
- S3 guideline thyroid carcinoma of the German Society for Nuclear Medicine e. V. (DGN), General and Visceral Surgery eV (DGAV) and the German Society for Endocrinology. In: AWMF online (as of: registered)
Professional organizations
The German Society for Phoniatrics and Pedaudiology is an amalgamation of predominantly scientifically active specialists in phoniatrics and pedaudiology, including many professorships from German universities. Any doctor for phoniatrics and pediatric audiology who can nominate guarantors from among the members can become a member. For doctors in further training there is the junior membership, which can be converted into full membership upon application after passing the specialist examination. The main task of society is to maintain a high scientific standard in the subject.
A member of the German Professional Association of Specialists in Phoniatrics and Pedaudiology also belongs to the board. This is an amalgamation of mainly practicing doctors. Any specialist can become a member. The task of the professional association is, among other things, to represent the interests of the profession, as well as to present the subject to authorities, medical and other organizations, in particular the medical associations and associations of statutory health insurance physicians.
statistics
The physician statistics of the German Medical Association as of December 31, 2017 list a total of 254 specialists, 109 of whom were registered in private practice and 92 as non-medical practitioners. In September 2017 there were 305 members in the DGPP .
The situation in Austria
There is no separate special subject phoniatrics in Austria, it counts as an additive subject (future term "specialization") of the special subject ear, nose and throat medicine.
According to the 2015 AEO, the ENT specialist training comprises 72 months with a final examination. This is followed by training in the phoniatrics-pediatric audiology specialization over a further 2 years with an independent examination at the end of the training.
Professional organizations
The Phoniatry Section is a sub-organization of the Austrian Society for Ear, Nose and Throat Medicine, Head and Neck Surgery. It pursues professional political goals, represents the interests of phoniatrics in relation to other medical organizations and authorities, advocates the further development of phoniatrics and pediatric audiology, including the training of doctors in this field, and is available to advise on specialist questions. In addition, she represents the specialized field of phoniatrics scientifically within the Austrian ENT Society. The members of the Phoniatrics Section must be specialists in ear, nose and throat diseases with the additional subject of voice and language diseases (phoniatrics) and at the same time members of the Austrian Society for Ear, Nose and Throat Medicine, Head and Neck Surgery.
In September 2016 the Phoniatry Section comprised 45 members.
International level organizations
At the European level there is the Union of European Phoniatrics, (UEP) internationally the Intl. Association of Logopedics and Phoniatrics (IALP).
literature
- Jürgen Wendler, Wolfgang Seidner, Ulrich Eysholdt: Textbook of Phoniatry and Pedaudiology . 4th edition. Thieme-Verlag, Stuttgart 2005, ISBN 3-13-102294-9 .
- Richard Luchsinger, Gottfried E. Arnold: Handbook of Voice and Speech Medicine, Vol. 1 and 2 . 3. Edition. Springer, Vienna-New York 1970, ISBN 3-211-80983-X .
- Markus Vieten: career planner doctor or what you can do with a medical degree . 5th edition. Thieme, Stuttgart-New York 2005, ISBN 3-13-116105-1 .
- Christian v. Deuster: Phoniatrics. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. Walter de Gruyter, Berlin and New York 2005, ISBN 3-11-015714-4 , p. 1155 f.
Web links
- German Society for Phoniatrics and Pediatric Audiology
- Phoniatrics Section of the Austrian Society for ear, nose and throat medicine, head and neck surgery
- Working group of the scientific medical societies
- Current training regulations (as an example, Bavarian Medical Association)
- History of Phoniatry and Tasks Today . (PDF file; 1.1 MB) pp. 23–24.
- History of the International Association of Logopedics and Phoniatrics (IALP) 1924-1998, 4th edition, 1999 (PDF file)
Individual evidence
- ^ Adolf Kussmaul: The disorders of the language. Leipzig 1877.
- ↑ Christian v. Deuster: Phoniatrics. In: Encyclopedia of Medical History. 2005, p. 1155 f.
- ↑ History in different nations ( Memento of the original from July 14, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ^ P. Biesalski: Phoniatrie-Pedaudiology. A new subject in clinical medicine. In: Speech-Voice-Hearing. Volume 3, 1979, pp. 43-45.
- ↑ Christian v. Deuster: Phoniatrics. In: Encyclopedia of Medical History. 2005, p. 1155 f.
- ↑ Further education plan of the UEMS and UEP ( Memento of the original from July 14, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ [1] Sample advanced training regulations of the BÄK as of 11/2018
- ↑ Model further training regulations 1992
- ↑ [2] BÄK overview page on doctors' statistics
- ↑ [3]
- ↑ Archived copy ( memento of the original from September 25, 2016 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ [4] Homepage of the UEP
- ↑ [5] Homepage of the IALP