Germany East
(German Democratic Republic, GDR)

Juergen Wendler (Berlin) and Johannes Pahn (Rostock)

Taken from Gutzmann-Festschrift (1980), updated and translated into English by J. Wendler

Development of the Specialty
Under the difficult conditions of life after the end of the 2nd World War, phoniatrics almost had come to succumbing completely. 1945, only H. Gutzmann jun. worked in the field of the then Soviet occupation zone in Berlin as head of the Charité ambulatory for the voice and speech/language disabled, together with Wethlo, the head of the phonetic laboratory. 1948, when Gutzmann was dismissed for political reasons, the ambulatory was attached to rehabilitative pedagogy, and there was no medical phoniatric department in Berlin anymore. Scholz from Goerlitz tried to provide medical support to the now pedagogic facilities in a self-sacrificing way. He also ran the first phoniatric postgraduate training course after the war in Berlin.

By the same time, Habermann started scientific and practical phoniatric work at the university ENT clinic in Leipzig, which led him to habilitation (Ph.D.) 1953. In Halle, Pfau dealt with phoniatrics in a systematic way from 1953 and founded in 1954, supported by the professor of otorhinolaryngology Eckert-Moebius, a new department. He started, together with the speech scientist H. Krech, director of the then Institut fuer Sprechkunde und phonetische Sammlung in Halle, the first phase of a new development of phoniatrics in East Germany. In 1960, a phoniatric course took place in Halle under the direction of Jakobi and Pfau, which caused keen interest and promoted the development of further facilities substantially. Essential centers arose in Jena (Siegert, 1958), Leipzig (Boehme, 1960), Greifswald (Gundermann, 1960, with the first clinical ward 1965), Erfurt (Pahn, 1960), and Berlin (Wendler, 1963) at that time. Several leading representatives of otolaryngology deserve thanks for their emphatic support: so mainly Eckert-Moebius and Jakobi (Halle), Mrs. Albrecht (Jena), Moser (Leipzig) Schroeder (Erfurt), Dietzel (Rostock), Zippel (Greifswald) and Krienitz (Berlin). It is the educational help of the Prague Phoniatric University Clinic, which is to stress particularly and gratefully in this connection. All of the phoniatricians growing up in the GDR (and young doctors from many other areas of the world) were allowed to work with Seeman as well as with E. Sedlá?ková and K. Sedlá?ek at that time. All ENT clinics of the universities and medical academies in East Germany established phoniatric departments soon, and the same was true for ENT departments of regional hospitals and for several policlinics.

Soon after the foundation of the “Gesellschaft fuer ORL und zerv.-faz. Chir. der DDR” in the beginning of the sixties, also a working group „Phoniatrics“ was formed and led by Moser, to deal with current problems. All ENT doctors working in the field of phoniatrics, they were 19 meanwhile, met from 1973 for regular conferences of this working group and started with a systematic development of their special field. In 1974, they published a „Plan on phoniatric care in the German Democratic Republic“ in coordination with the Ministry of Public Health. This plan was based on recommendations of the Union of the European Phoniatricians, and its stepwise realization was included into the general governmental planning. From this gets clear, that the Ministry pursued and supported the efforts of the phoniatricians with interest.

On December 7, 1974, a Section of Phoniatrics was constituted in the frame of the ORL Society, directed by an executive board of their own (Wendler, Reinsch, Siegert), which became a corporative member of the Union of the European Phoniatricians (UEP) and organized the VIth Congress of UEP in Weimar, 1977. In the same year, governmental recognition of phoniatrics as an official field of subspecialization to otorhinolaryngology was achieved with a specific training program of 2 years. The postgraduate education for phoniatricians was supervised by an expert group of 5 phoniatricians appointed by the Academy for Postgraduate Education of the GDR. Some 80 colleagues accomplished this program and, thus, became specialists for ENT/phoniatrics.

There were phoniatric postgraduate courses for ENT doctors since 1973, organized by the Academy for Postgraduate Education, which also introduced annual postgraduate courses for all phoniatricians of the country since 1979. But also for ENT trainees and supervisors for ENT training, phoniatric courses were available in Jena, Rostock, and Berlin, and regional events like the Rostocker Phoniatrierunden (Pahn) or the Berliner gesangswissenschaftliche Tagungen (Seidner) completed the postgraduate program.

Students of medicine and stomatology received a short introduction to phoniatrics (4 or 2 lectures and 2 seminars) in the context of the ENT program. For postgraduate education in otorhinolaryngology, a 3 months’ training at a phoniatric department was obligatory. Both for the students’ ENT examen at medical schools and at the central ENT examinations for medical specialization, phoniatrics was an obligatory integrated part. The High Schools of Music in Berlin, Dresden, Leipzig and Weimar maintained close relations to their regional phoniatric departments, which took corresponding educative obligations (physiology and hygiene of the voice for students of singing) usually. A subject area „audiology phoniatrics assistant“ was established at the medical technical colleges in Halle, Jena, Greifswald and Erfurt. The period of training was 3 years.

The scientific development of the specialty was promoted essentially by the phoniatric symposia with international participation, initiated by Moser in Leipzig 1963. Main topics covered all areas of phoniatrics, as there were experimental basics, endocrinology, hearing and information, hearing impaired children, larynx and respiration, expert opinions, therapeutic methods, methods of investigation, stuttering, cluttering, functional dysphonias, delayed speech/language development, dyslalias, aphasias, neurologic disorders etc..

In the following, some main fields of work shall be mentioned and some results shall be quoted.

Voice Physiology
The new ideas about voice production published by Husson were, also in the GDR, motivation for experimental studies that contributed to the refutation of the so-called neurochronaxic theory. Pfau (1960) at first checked the nervous supply for the larynx by electrical stimulation of the laryngeal nerves of the dog, and in his results stressed that, by the contraction of the M. cricothyroideus, the anterior part of the cricoid is pulled towards the thyroid and not reverse (thyroid towards cricoid), as it was shown in most textbooks until then. This proved an essential aspect of the function of the laryngeal framework: the tilting movement of the cricoid allows stretching the vocal folds.

Measurements of vocal folds’ length (Pfau 1961; Wendler, 1966) confirmed the assumption that with increasing pitch the vocal folds become longer and, thus, more tense. These observations supported the myoelastic basis of voice production. The results of Husson’s investigations on the coherences of chronaxia and voice category could not be confirmed (Pfau, 1962). Experiments on the metabolism of the human laryngeal musculature in view of the LDH isoenzym distribution (Hanson and Lotz, 1973) proved once more that the special biochemical activity of the M. vocalis to be demanded after Husson couldn’t be substantiated.

Flach et al. (1966) discussed the acoustic meaning of the recessuses piriformes by means of laryngographic and sound analyses related examinations. With their influence eliminated, the intensities of partial tones were found reduced in the higher formant area. With similar methodology, the same authors (1968) took position to the question of the influence of hereditary factors on the sound characteritistics of the voices of twins. Far-reaching concordance arose with respect to the dimensions of larynx and trachea as well as to the intensity and number of the partials in the spectrogram in the context of identical twins, while non-identical twins showed clear differences at these features. Flach et al. (1973), who dealt with problems of the singing voice in several papers, mentioned also the pneumatization of the frontal sinus in singers and came to the end that normal or large-scale frontal sinuses are of importance for the perception of certain sensations of vibration.

Studies on the intraindividual spectral variability of the human voice sound (Wendler, 1972) revealed that changes of the sound of the voice as a function of pitch and voice power follow definable rules, what is important for the judgment of voice qualities.

Pfau (1967, 1973) presented an extensive, clinical and experimental study on the classification of the human voice (voice classes) in the context of his habilitation (Ph.D. thesis).

Overtone singing (or formant singing) was object to experiments that clearly indicated resonatory features of the vocal tract as the generating principles (Wendler et al., 1988).

Voice Diagnostics
The perceptive judgment of voice qualities and degrees of distortion still remains an essential basis of diagnostics. Primarily, the section of phoniatrics followed suggestions from Pahn (1976) and Wendler (1973). Later on, the so-called RBH system (Wendler et al., 1986, Nawka and Anders, 1996) was widely accepted, with the qualitative parameters R for roughness due to vibratory irregularities of the vocal folds and B for breathiness due to turbulences of unmodulated air caused by incomplete closure, while H stands for the general, quantitative measure hoarseness and describes noise components of any origin. All parameters are indicated as 0 = not existing, 1 = low degree, 2 = medium degree, 3 = high degree according to subjective assessments. This system, similar to the Japanese GRBAS scale, turned out to be quite useful as a basic tool for practical application.

As for the judgment of the vocal fold vibrations, stroboscopy has gained general acceptance. Statements on the phonatory conditions during the stroboscopic investigation should, generally, be part of the documentation, because, the stroboscopic phenomena vary widely with pitch and intensity of phonation (Wendler, 1967). The development of microstroboscopy (Seidner et al. 1972) resulted in a new quality of the findings and, thus, led to an essential improvement in diagnostics as well as in therapy as far as indirect operations on the vocal folds are concerned.

The introduction of photokymography of the larynx (Gall et al. 1973, 1974, 1978) opened up new perspectives for a thorough analysis of the real vibratory pattern of the vocal folds with all essential parameters included.

Electroglottographic examinations led to more exact definitions of the single curve (Reinsch et al. 1972) as well as for the recording of new parameters at the registration of the course of the overall curve (Jentzsch et al. 1978): vibratory onset, declining time, amplitude quotient. These parameters were recommended for the differentiation of functional dysphonias.

The hopes put into pneumotachography (Stuerzebechers et al. 1973), unfortunately, did not come true. Studies from Seidner et al. (1974, 1976) as well as from Bastian et al. (1978) demonstrated that the method, due to very wide intra- and interindividual variability of the measures, is not useful for diagnostics.

Unger (1978) summarized the results of pneumotachographic and electroglottographic examinations (overall curve) in a doctorate B (Ph.D.) thesis. The comparison of electroglottographic and pneumotachographic parameters led, as to this publication, to better founded assessments regarding diagnostics, therapy and prophylaxis of voice disturbances.

Siegert (1969) chose the intraoesophageal pressure in reference to the subglottic pressure and the sound pressure level of the radiated voice as basic parameters for fitness examinations of the voice. Hoefner et al. (1975, 1978) carried out extensive mathematical processing of corresponding data and calculated normal values. They arrived at the conclusion that this complex method provides exact information on the degree of vocal efficiency, typical vocal behavior etc. by the measures of phonatory threshold and degree of vocal efficiency. This should be an objective basis for voice diagnostics. By additional recording of frequency and respiratory parameters (abdominal and thoracic pneumogram), Siegert also strived for a qualitative assessment of the speaking and the singing voice.

Investigations on the commanding voice (Kuehn, 1976, 1977, 1979) showed that the subglottic pressure, due to high variability, does not allow a definite separation of pathological voices. As for the performance of the commanding voice, the relationship of minimum to maximum volume of the voice is an essential criterion.

Pahn et al. (1976) used the effective sound pressure of a definite disturbing noise in dB that regulably conceals the vowels and voiced consonants, as measure for the vocal penetration power. The statement is given in dB disturbing noise at 50% comprehensibility.

The automatic voice range profile measurement (also called phonetogram) including the intensity of the high formant region as introduced by Seidner, Rauhut et al. (1979) allows a quick overview on the basic voice functions and provides very special statements in the assessments of singing voices (e.g. vowel equalization, register handling). A standard was set and recommended by UEP (Seidner, Schutte, 1982), and Seidner et al. (1985) made a proposal for numerical interpretations. Voice range profile measurements have been widely adopted meanwhile and are part of basic voice assessments in many areas of the world.

First experiments with long-term average spectral analyses (LTAS) of running speech (Wendler et al. 1979) were considered encouraging. The method may provide not only an objective classification of degrees of hoarseness, but also an essential help in the search for diagnoses.

Clinic
The achievements of phoniatrics in the GDR on clinical sector were determined strongly by the education of the phoniatricians as subspecialists of otorhinolaryngology. Every phoniatrician was an ENT specialist and had the whole spectrum of this education at his disposal, e.g. also on the operative field.

Pfau (1969) and Jung (1971) dealt with intubation damages. Pfau pointed to recurrent nerve and internus pareses besides the well-known formations of granulomas after intubation. In numerous preoperative examinations of children, Jung observed pathological laryngeal findings already before the intubation, so that damages might be feigned. Pfau (1973) showed by histological investigations that for the emergence of granulomas epithelial lesions and bacterial infections play a favoring role. Simultaneously, in many cases of granulomas, vocal fold polyps and Reinke’s edema, an increased voice loading seems to be of meaning. Therefore, a durable success can be expected only by an additional training therapy despite of operative removals, as a rule. The observation of Pfau seems to be considerable that descending inflammations and allergy are, contrary to many references, of minor meaning in the etiology of Reinke’s edema.

Wendler (1969) reported of endolaryngeal operations in indirect microscopy. He recommended, on proposal of Seidner (1972), indirect microstroboscopic technology later. They stressed the functional aspects of indirect endolaryngeal phonosurgery with the patient awake: visual as well as perceptual monitoring during the intervention allow very precise manipulations, even on smallest lesions. Long-term follow-up studies on 571 out of more than 5000 operations revealed positive results in the order of more than 90% (Wendler a. Seidner, 1978, 1991), and all of the operated singers (more than 100 mean-time) returned to their usual performances without any restrictions (Seidner, 1989). Thyroplastic procedures according to Isshiki were introduced successfully and modified (Wendler, 1984) as well as Laser-arytenoidectomies. The use of Laser-techniques in phonosurgery was systematically studied and applied by Nawka (1993). A new approach to pitch raising by shortening of the vibrating glottis was established (Wendler, 1990).

Tonsillectomy in voice professionals has provoked discussions, particularly with singers, again and again. Flach et al. (1965) carried out frequency analyses related to vocal results after 42 tonsillectomies. Practically, no negative acoustic changes arose so that the operation can be recommended in this regard. Pfau (1954) however also mentioned the dangers with nervous singers and declines the tonsillectomy here without indicatio vitalis. An unfavourable prognosis can be expected after Pahn (1975), if chronic pharyngitis, particularly lateralis, considerable dysaesthesias and a strong functional component of disturbance already exist prior to tonsillectomy.

Pfau (1965) dealt with alloplastic implants at unilateral vocal fold paralyses and, because of the same inert qualities as teflon (polytetrafluoraethylen), recommended Ekafluvin (polytrifluormonoaethylen) produced here. Pahn (1974) took position to the operative voice improvement at homolateral N. recurrens and N. laryngeus superior pareses. The mostly extreme voice disturbance is explicable with the great difference of tension between the two vocal folds and can be improved decisively by elimination of the contralateral M. cricthyroideus and additional voice therapy.

Observations on voice virilizations after treatment of women and children with heterosexual hormones and anabolic steroids were the starting point for examinations on hormonal dysphonias) Wendler, 1968, Tzschoppe et al., 1974; Zehmisch, 1974). Ovulation inhibitors also can trigger voice alterations under certain conditions in terms of an incipient virilization and may affect highly qualified vocal performances as required in professional singing (Wendler, 1969, 1972; Pahn, 1978).

Heidelbach et al. (1969) pointed at laryngological phoniatric aspects in Acromegalia, and Schleier et al. (1977) reported about phoniatric findings in children with primary congenital hypothyreosis. While local changes determine the symptoms of Acromegalia in the laryngeal and pharyngeal area, congenital hypothyreoses primarily cause delays of speech-language development in connection with oligophrenia, psychomotoric deceleration as well as inner ear hearing loss.

Heinemann (1974) presented a summarizing report on voice and speech/language disorders (Ph.D. thesis) as a result of endocrinological diseases as well as about iatrogenic hormonal disturbances after androgenic or anabolic hormones.

In the area of the oncology, Hanson and Bruchmueller (1978) dealt with precancerous lesions of the larynx with regard to katamnestic, clinical diagnostic and scanning microscopic examinations.

Two kinds of chronic laryngitis can be distinguished: a) the flat parakeratotic and b) the granulating hyperplastic one. The latter led to a larynx carcinoma in 25% of all cases. The papillary keratosis (after Kleinsasser) requires special attention in this regard. The malign degeneration rate was higher than with the flat and verrucose keratosis. As an important diagnostic aid, the toluidine blue test (Richart) of the mucous membrane was stressed.

In the rehabilitative sector, Schleier (1976) dealt with voice function related results after radiotherapy and chordectomy for vocal fold carcinomas. The results permit the conclusion that, for the choice of the clinical procedure, the analyses of the final functional results should be included in the consideration, naturally with respect to the stage and the best possible success of treatment quoad vitam. Phoniatric postoperative care is to be recommended in every case.

The results of treatment at voice disturbances as well as the comparability of the successes of treatment received increasing attention. The first effort in this direction did Wendler (1966) on the basis of a differentiated evaluation of 600 patients. In agreement with Siegert (1965), he came to the end that for the assessment of a neurosis as cause for voice disturbances, caution is demanded. Riess et al. (1976) continued with the assessment of therapeutic successes on the base of 750 patients with check-ups 4 1/ 2 years (on average) after the first treatment. For the therapy of vocal fold nodules, the microstroboscopic removal with subsequent training therapy proved as clearly favourable compared to the purely conservative methods. Parents counselling was in the foreground in children with nodules. Hanson (1976) arrived at the same result after examinations of 70 children with hyperfunctional dysphonias. An extensive study on the results of treatment by training therapy of voice and speech/language disorders on the base of 4 000 patients came from Ulbrich et al. (1977), with details on frequency distribution, diagnosis, age-group, profession and possibility for documentation. Another suggestion to improve comparability was published by E. Pahn (1977). 10 different methods of investigation or measurings, which include the complete communication chain, are used to objectify the results of treatment. The practical application of the scheme is shown at the success of treatment of voice disturbances that exclusively can be traced back to wrong use.

The efforts on improvements in the comparability of the result of treatment require new agreements on terminology (Wendler et al. (1973). The symptomatic main groups „hyper and hypofunctional dysphonias“ were subdivided into four etiologically orientated subgroups: constitutional, habitual, ponogenic and psychogenic. The voice qualities were related to assessments of the phase of closure and regularity of the vocal fold vibrations, to the resonance features of the vocal tract and to vocal intensity. Questions of terminology have been under permanent, fruitful discussion, also in the frame of UEP.

In a summary-like presentation on the coherences between voice, language and the orofacial system, Heidelbach (1975) pointed at essential bases for further studies. Boehme (1966) had preceded with his Ph. D. thesis about disturbances of language, voice and hearing due to brain damages in early childhood. This textbook-like publication is valid on theoretical and diagnostic sectors to this day. Wendler et al. raised the therapeutical side (1969) with statements on the prognosis of children’s speech/language disorders.

An essential contribution to the problems of stuttering came from Siegert An essential contribution to the problems of stuttering came from Siegert et al. (1974) with an analysis of about 500 stutterers in the age of 5 to 14 years based on EEG findings. After this, the EEG was taken out of routine diagnostics of monosymptomatic stuttering. Zehmisch (1963) dealt with the stutterer in military service, according to which the fitness for service was made dependend, generally, on language negotiability. Wendler (1981) presented an overview on current aspects and therapeutic strategies in stuttering based on an international questionnaire campaign covering more than 10.000 treated patients. For stuttering in early childhood, the indirect approach (intensive parents counselling only, no direct speech therapy) was considered to lead to the best results.

A larger number of papers on diagnostics, therapy and rehabilitation of cleft patients dates from Muehler (1965, 1969, 1971, 1972, 1975). His functional assessments of pharyngeal plastics, according to the criteria R (Resonance features), D („nasale Durchschlaege“, nasal blows), V („Artikulationsstellenverlagerung“, articulatory posture deviations) und M (mimic disturbances) attracted special attention. The degrees of severity 0 to 3 as indices to capitals led to a new quality in the assessment of success.

Concerning late phoniatric therapy for cerebral palsy, spastic children, there is a paper of E. and J. Pahn (1972).

Suitability, Fitness
Phoniatric fitness examinations for professions with extraordinary voice and speaking load were a common issue of all phoniatricians of the GDR and they were developed with quite special interest. The result was a well-organized, obligatory fitness examination of all applicants for studies of these professional groups on a legal basis.

First beginnings of these examinations go back to Krech, who, as speech scientist and speech trainer, examined students of pedagogics as early as in 1950 and drew attention to questions of education and suitability and fitness. In 1966 and 1967, Siegert was the first phoniatrician to report on medical efforts and experiences in this field. He was followed by Gundermann et al. (1967), Pahn et al. (1969) and Gundermann again (1970) with his monograph on the professional dysphonias. As from the middle of the sixties, there were several local settlements based on individual arrangements between the matriculating training facilities and single phoniatric departments. An essential organizational step was reached 1971 by Pahn with an official regulation for the district of Rostock regarding systematic examinations of all educational applicants for studies („Rostock model“).

Making use of all these experiences, a uniform introduction of fitness examinations in the entire country was achieved in 1974 via a common directive of the ministries for health services and for higher education. This result proved, in return, to have a further stimulating effect on the development of phoniatrics.

The further scientific foundation of this system, after 1970, was promoted, particularly, by the work of Boehme (1971), Pahn (1972, 1974), Seidner et al. (1972), Heinemann (1972), Schleier (1975), J. Pahn et al. (1976a), Hanson et al. (1976), and J. Pahn et al. (1976b).

Whilst the earlier work was aiming mainly at rationales of the necessity, the topic of investigation and the rates of rejections, later studies refer to criteria of investigation and already to first results of success. The working group „fitness“ of the section of phoniatrics with Heidelbach, Heinemann, Pahn and Zieger could, finally, summarize the essential cognitions and suggest criteria for the investigations, which were adopted by the section in 1977 as obligatory. After the introduction of a uniform documentation at all phoniatric facilities in the GDR (Heidelbach, 1981), Heidelbach collected the data of some 100.000 subjects and reported on several occasions about preliminary results. He died, before he could complete this unique work. R. Berger (1988) extended the scope to questions of inability to work in voice intensive professions (expert opinions).

This program required the formation of uniform valuation scales and common procedures for the valuation. It also made a good base for new fields of research, particularly the elaboration of professiograms in voice professions, which have a decisive influence on the criteria of investigation after today’s knowledge. An earlier attempt at professiograms based on the work of speech trainers had been made by Siegert 1965. Detailed investigations on the interrelations between noise and voice were carried out by Siegert (1966, 1967), Pahn (1974), Schleier (1977), and Klingholz et al. (1978). A dominating roll of the noise was found as to the etiopathogenesis of voice disturbances, an issue, which might be object of further examinations. All of the authors agreed that not only various noise intensities, but also the qualities of the noise lead to certain voice speech related reactions with high meaning for voice diseases. The latter are seen, according to Klingholz et al., increasingly from the 3rd year of work up to the 7th year of work in the noise environment. Further examinations of J. Pahn et al. (1976 B) draw the attention to the roll of the constitutional voice power and offered a practicable measurement procedure. After this, a „constitutionally middle voice“ ranges, under the condition of a microphone distance of 10 cm, from 80 to 84 dB at normal speaking loudness, from 90 and 94 dB at maximum speaking loudness without increase in speaking pitch, and from 100 and 104 dB at calling voice. „Small“ voices are below, „great“ voices above these ranges. The constitutionally small voice is subject to a special high endangering in voice professions with a certain noise loading.

The training and the professional use of the singing voice put very special demands on the fitness examinations. There is no doubt that the very first investigations on vocal fitness were carried out in this professional area, but, more by singing teachers than by medical doctors. Meantime, competent phoniatricians were responsible for the fitness examinations of students of singing at the musical high schools: Behrendt (Leipzig), Flach and Heidelbach (Dresden), Seidner (Berlin) and Siegert (Weimar). Heidelbach (1976) wrote his Ph. D. thesis about the topic of the suitability and fitness for the singer’s profession. Main topics were methods of investigation, electronic databases and processing, valuation of findings and criteria, the roll of the personality, classification of voice categories, and statements on the reduction of the dropout rate. Seidner (1985) reported on 20 years of experiences with singing students in Berlin. The fitness examinations for the three major children’s and youth choirs were in the hands of Behrendt (Thomaner-Chor, Leipzig), Heidelbach (Kreuz-Chor, Dresden) and Pahn (radio youth choir, Wernigerode).


Literature
(including a few publications which appeared after 1990, but were based on work done before)

Books
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Böhme, G.: Untersuchungsmethoden der Stimme und Sprache. Leipzig: Barth 1972.

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Heinemann, M.: Stimm- und Sprachstörungen als Folge endokrinologischer Krankheitsbilder sowie iatrogene Hormonstörungen bei Gabe androgener oder anaboler Hormone, Med. Habil.-Schr. Leipzig 1974. Hormone und Stimme. Leipzig: Barth 1976.

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Mühler, G.: Sprachliche Rehabilitation. In: Spezielle Zahn-, Mund- und Kieferheilkunde. Hrsg. von Rosenthal, Bethmann und Bienengräber. Leipzig: Barth 1971.

Nawka, T.: Endoskpoische Mikrochirurgie des Larynx mit dem CO2 –Laser. Med. Habil.-Schr. , HU Berlin 1993

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Pfau, W.: Die Klassifizierung der menschlichen Stimme. Med. Habil.-Schr. Halle 1967. Leipzig: Barth 1973.

Seidner, W.: Beiträge zur apparativen Stimmuntersuchung in der phoniatrischen Praxis. Med. Diss. B, HU Berlin, 1984

Siegert, C.: Die intraösophageale Druckmessung, eine Möglichkeit zur Darstellung der Stimmfunktion. Med. Habil.-Schr. Jena 1969.

Siegert, C.: Entwicklung der Sprache und des Sprechens. In: Phoniatrie und Pädoaudiologie. Hrsg. von P. Biesalski, G. Böhme, F. Frank und R. Luchsinger. Stuttgart: Thieme 1973.

Unger, E.: Die Erfassung und Bewertung objektiver Parameter des Stimmapparates mittels der Elektroglottographie und der Pneumotachographie. Med. Habil.-Schr. Erfurt 1978.

Wendler, J.: Die physiologische Variabilität der Frauenstimme. Med. Habil.-Schr. Halle 1969.

Wendler, J.: Stimm- und Sprachkrankheiten. In: Gerhardt, H.-J.: Vademekum der HNO-Heilkunde. 1. Aufl. Leipzig: Thieme 1974. 2. Aufl. Leipzig: Thieme 1978.

Wendler, J.; Seidner, W.: Grundlagen der Phoniatrie. In: Die Erkrankungen an Hals, Nase, Ohr und an den oberen Luft- und Speisewegen. Hrsg. von F. Moser. 2. Aufl., Jena: Fischer 1986

Articles
Bastian, H.-J.; Sasama, R.; Unger, E.: Aerodynamische Leistungsprüfung und Funktionsdiagnostik der normalen Frauenstimme. Folia phoniat. 30 (1978), 85-93.

Berger, R.: Berufsunfähigkeit bei Pädagogen - eine phoniatrische Analyse aus Berlin-Leipzig-Dresden. HNO-Praxis 14 (1989), 153-158

Flach, M.; Schwickardi, H.: Über die Folgen der Septumresektion und Tonsillektomie beim Sänger, objektiviert durch elektroakustische Klanganalysen. Folia phoniat. 17 (1965), 129-149.

Flach, M.; Schwickardi, H.: Die Recessus piriformes unter phoniatrischer Sicht. Folia phoniat. 18 (1966), 153-167.

Flach, M.; Schwickardi, H.; Steinert, R.: Zur Frage des Einflusses erblicher Faktoren auf den Stimmklang (Zwillingsuntersuchungen). Folia phoniat. 20 (1968), 369-373.

Flach, M.; Schwickardi, H.; Köhler, H.: Die Stirnhöhlenpneumatisation beim Sänger. Mschr. Ohrcnheilk. 107 (1973) 543-549.

Gall, V.; Hanson, J.: Bestimmung physikalischer Parameter der Stimmlippenschwingungen mit Hilfe der Larynx-photokymographie. Folia phoniat 25 (1973), 450-459.

Gall, V.; Hanson, J.; Freigang, C.: Zur Larynx-Fotokymografie: Demonstration einiger pathologischer Kehlkopf-Befunde. Mschr. Ohrenheilk. 108 (1974), 114-122.

Gall, V.: Fotokymografische Befunde bei funktionellen Dysphonien, Kehlkopflähmungen und Stimmlippentumoren. Folia phoniat. 30 (1978), 28-35.

Hanson, J.; Bartelt, J.; Kluge, G.; Passolt, W.: Zur Prognose kindlicher Stimmstörungen. HNO-Praxis 1 (1976), 170-174.

Hanson, J.; Lotz, P.: Die Energiestoffwechsellage der menschlichen Kehlkopfmuskulatur aus der Sicht der LDH-Isoenzymverteilung. Mschr. Ohrenheilk. 107 (1973), 218-225.

Hanson, J.; Kluge, J.; Passolt, W.; Bartelt, J.: Ergebnisse der phoniatrischen Begutachtung von 240 Studienbewerbern für pädagogische Berufe anhand einer Längsschnittuntersuchung. Wiss. Z, Univ. Greifswald 25 (1976), 247-252.

Hanson, J.; Bruchmüller, W.: Untersuchungen zur Intravitaldiagnostik von Kehlkopfkarzinomen und ihren Vorstufen. HNO-Praxis 3 (1978), 249 - 254.

Heidelbach, J.-G.; Toelle, D.: Laryngologisch-phoniatrische Aspekte bei der Akromegalie. Folia phoniat. 21 (1969), 63-73.

Heidelbach, J.-G.: Die Stimme und die Sprache - ihre Beziehungen zum orofazialen System und die Bedeutung für bestimmte Berufsgruppen. Zahn- Mund- u. Kieferheilk. 63 (1975), 356.

Heidelbach, J.-G.: Zum Problem der edv-gerechten Dokumentation von Grundbefunden in der Routinepraxis der Phoniatrie. HNO-Praxis 6 (1981), 228

Heidelbach, J.-G.; Heinemann, M.; Pahn, J.; Zieger, K.: Die phoniatrische Beurteilung der Tauglichkeit für Sprechberufe. HNO-Praxis 2 (1977), 59-60.

Höfner, G.; Siegert, C.: Beitrag zur objektiven-komplexen Leistungsdiagnostik des Stimmorgans. Wiss. Z. FSU Jena (1975), 137-148.

Höfner, G.; Siegert, C.: Beitrag zur objektiven-komplexen Leistungsdiagnostik des Stimmorgans. II. Mitteilung. Wiss. Beitr. FSU Jena (1978), 164-170.

Jentzsch, H.; Sasama, R.; Unger, E.: Elektroglottographische Untersuchungen zur Problematik des Stimmeinsatzes bei zusammenhängendem Sprechen. Folia phoniat. 30 (1978), 59-66.

Jung, H.-P.; Steude, G.; Tzschoppe, A.: Laryngologische und phoniatrische Untersuchungen bei Kindern vor und nach Intratrachealnarkose. Dtsch. Ges. wesen 26 (1971), 655-657.

Klingholz, F.; Siegert, C.; Schleier, E.; Thamm, R.: Lärmbedingte Stimmstörungen bei Angehörigen unterschiedlicher Berufsgruppen. HNO-Praxis 3 (1978), 193-201.

Kühn, E.: Experimentelle Untersuchungen zur objektiven Beurteilung der Kommandostimme. Z. Militärmed. 17 (1976), 23-27.

Kühn, E.: Intrathorakale Druckverhältnisse bei der Kommandostimme. Z. Militärmed. 18 (1977), 55-57.

Mühler, G.: Über die Bedeutung und Aufgaben der Phoniatrie und Audiologie bei der Rehabilitation von Gaumenspaltenträgern. Dtsch. Ges. wesen 20 (1965), 725-729.

Mühler, G.: Mandelentfernung bei Patienten mit Gaumensegelspalten. Z. Laryng. Rhinol. 51 (1972), 806-815.

Mühler, G.: Spezielle kieferchirurgische Massnahmen zur Verhütung und Behandlung von Sprachstörungen. Öst. Ärztetg. 30 (1975), 547.

Nawka, T., Anders L. Ch.: Die auditive Bewertung heiserer Stimmen nach dem RBH-System. Doppel-Audio CD mit Stimmbeispielen. Thieme, Stuttgart, 1996

Pahn, E.; Pahn, J.: Die phoniatrische Spätbehandlung zerebralparetischer, spastischer Kinder. Folia phoniat. 24 (1972), 57-64.

Pahn, J.; Dahl, D.; Pahn, E.: Der Stimmschalldruck als Tauglichkeitskriterium für pädagogische Berufsgruppen. HNO-Praxis 1 (1976),180-185.

Pahn, J.: Operativer Therapiebeitrag zur Stimmverbesserung bei einseitigen kompletten Rekurrensparesen. Proc. 16th Congr. IALP. Interlaken 1974. Basel: Karger 1976, S. 366-372.

Pahn, J.; Pahn, E.: Vorschlag zur Einschätzung des Schweregrades von Stimmstörungen. Logopedie en Foniatrie 48 (1976), 49-55.

Pahn, J.; Pahn, E.; Dettmann, R.: Messung des stimmlichen Anteils der Sprachverständlichkeit. 17th Congr. IALP. Copenhagen 1977. Folia phoniat. 28 (1976), 276.

Pahn, J.; Göretzlehner, G.: Stimmstörungen durch hormonale Kontrazeptiva. Zbl. Gynäkol. 100 (1978), 341-346.

Pahn, J.; Neumann, G.: Schlussfolgerungen zu Ergebnissen ganztätiger Lärmmessungen in neuerbauten Kindergärten. Z. ges. Hyg. 25 (1979), 167-171.

Pfau, W.: Tonsillektomie und Stimme. Z. Laryng. Rhinol. 33 (1954), 39 -.47.

Pfau, W.: Elektrische Reizversuche an den Kehlkopfnerven des Hundes. Arch. Ohren-usw. Heilk. 176 (1960), 735-740.

Pfau, W.: Zur Frage der Stimmlippenverlängerung beim Aufwärtssingen. Arch. Ohren-usw. Heilk. 177 (1961), 458-466.

Pfau, W.: Chronaxie und Stimmgattung. Folia phoniat. 14 (1962) 1-14. Pfau, W.: Erfahrungen mit alloplastischen Stimmbandimplantaten. 13th Congr. IALP. Wien 1965. Acta z. S. 147.

Pfau, W.: Stimmschäden nach Intubation. HNO (Beil.) 17 (1969), 45-46.

Pfau, W.; Knolle, H.: Die Behandlung des Reinkeschen Ödems und der Larynxgranulome. Folia phoniat. 25 (1973), 225-233.

Rauhut, A.; Stürzebecher, E.; Wagner, H.; Seidner, W.: Messung des Stimmfeldes. Folia phoniat. 31 (1979), 119-124.

Reinsch, M.; Gobsch, H.: Zur quantitativen Auswertung elektroglottographischer Kurven bei Normalpersonen. Folia phoniat. 24 (1972), 1-6.

Riess, F.; Wendler, J.: Katamnestische Erhebungen bei Patienten mit Stimmlippenknöchen und -polypen. HNO-Praxis 2 (1976), 111-116.

Schleier, E.: Phoniatrische Befunde bei Studienbewerbern für Sprechberufe und bei Pädagogikstudenten. Dtsch. Ges.-wesen 30 (1975) 17941798.

Schleier, E.; Siegert, C.; Klingholz, F.: Funktionelle Ergebnisse nach Strahlentherapie und Chordektomie von Stimmlippenkarzinomen. Z. Laryng. Rhinol. 55 (1976), 464-469.

Schleier, E.: Klinische und stroboskopische Befunde bei Lärmarbeitern. Dtsch. Ges.wesen 32 (1977), 123-126.

Schleier, E.; Hesse, V.; Finsterer, J.: Phoniatrische Aspekte bei primären kongenitalen Hypothyreosen. Dtsch. Ges. wesen 32 (1977), 5.751757.

Schönberger, A.; Hanson, J.; Riemer, V.: Funktionsbeurteilung von Pharynxplastiken nach dem Klassifikationsschema von Mühlen Zahn-, Mund- u. Kieferheilkd. 65 (1977), 870-874.

Seidner, W.: Objektive Qualitätsbeurteilung der Stimme mittels Dynamikmessung. Z. Klin. Med. 40 (1985), 1521-1525

Seidner, W.: Assessments in vocal aptitudes in student singers. – 20 years experiences in Berlin. Acta Phon. Lat. 7 (1985), 345-348

Seidner, W., H.K. Schutte: Empfehlung der UEP: Standardisierung Stimmfeldmessung/Phonetographie. HNO-Praxis 6 (1982), 305

Seidner, W., H. Krüger, K.-D. Wernecke: Numerische Auswertung spektraler Stimmfelder. Sprache-Stimme-Gehör 9 (1985), 10

Seidner, W.; Wendler, J.; Halbedl, G.: Mikrostroboskopie. Folia phoniat. 24 (1972), 81-85.

Seidner, W.; Stürzebecher, E.: Variabilität normaler Phonopneumotachogramme. 17th Congr. IALP. Copenhagen 1977. Folia phoniat. 28 (1976), 289.

Siegert, C.: Zur Auswahl des künftigen Schulmusikers vom medizinischen Standpunkt. Dtsch. Ges.wesen 19 (1964), 215-217.

Siegert, C.: Zur Problematik der funktionellen Stimmstörungen bei pädagogischen Berufssprechern. Dtsch. Ges.wesen 20 (1965), 969-975.

Siegert, C.: Zur Frage der einheitlichen medizinischen Beurteilung pädagogischer Studienbewerber. Z. Ärztl. Fortb. 60 (1966), 1134-1135.

Siegert, C.; Dieroff, H. G.: Tonhöhenverschiebung unter Lärmbelastung. Folia phoniat. 18 (1966) 247-255.

Siegert, C.: Der intrathorakale Druck und seine Beziehungen zur Stimmfunktion. Folia phoniat. 21 (1969) 28-104.

Siegert, C.; Daute, K. H.; Klust, E.; Kunze, E.; Müller, G.: Stottern, Zerebralschaden und EEG: Analyse von rund 500 Stotterern im Alter von 5 - 14 Jahren. Folia phoniat. 26 (1974), 222-223.

Stürzebecher, E.; Seidner, W.; Wagner, H.; Wendler, J.: Erfassung von Aterngrössen während der Phoniation. Mschr. Ohrenheilk. 107 (1973). 271-278.

Ulbrich, H.; Simon, B.; Wendler, J.; Heinicke, A.-M.: Zur übungstherapeutischen Arbeit an einer phoniatrischen Abteilung. Folia phoniat. 29 (1977). 127-145.

Unger, E.; Bastian, H.-J.: Phoniatrische Kriterien zur Tauglichkeit von Studienbewerbern. Dtsch. Ges.wesen 31 (1976). 2000-2003.

Unger, E.; Unger, H.; Tietze, G.: Stimmuntersuchungen mittels der elektroglottographischen Einzelkurven. Folia phoniat. 33 (1981), 168-180

Wendler, J.: Stimmlippenlänge und Tonhöhe. Z. Laryng. Rhinol. 45 (1966) 355 - 369.

Wendler, J.: Behandlungsergebnisse bei funktionellen Dysphonien. Folia phoniat. 18 (1966) 401-416.

Wendler, J.: Die Bedeutung der Stimmstärke bei der stroboskopischen Untersuchung. Folia phoniat. 19 (1967) 73-88.

Wendler, J.: Endolaryngeale Eingriffe in indirekter Mikroskopie ohne Zusatzoptik. HNO (Berl.) 17 (1969) 158.

Wendler, J.: Zur intraindividuellen spektralen Variabilität des menschlichen Stimmklangs. In: Papers in interdisciplinary speech research. Proc. speech symp. Szeged 1971. Ed. by J. Hirschberg, Gy. Szepe and E. Vass-Kovácz. S. 197-200.

Wendler, J.: Zyklusabhängige Leistungsschwankungen der Stimme und ihre Beeinflussung durch Ovulationshemmer. Folia phoniat. 24 (1972) 259-277.

Wendler, J.: Stotternde in der phoniatrischen Praxis: Folia phoniat. 33 (1981), 181-188

Wendler, J.: Glottoplasty for raising pitch. Abstr. 3rd Intern. Symp. on Phonosurgery, Kyoto 1994, p. 63

Wendler, J.: Cebulla, M.; Völker, L.: Production of isolated overtones during normal phonation. UMATIC video, 8 min., 1989

Wendler, J.; Fischer, S.; Kaschke, O.: Voice after unilateral arytenectomy. Intern. Symp. Phonosurgery and Phoniatrics, Karlovy Vary, August 11-13, 1989, p.13

Wendler, J.; Müller, K.; Kohlheb, 0.; Ulbrich, H.; Simon, B.: Zur Prognostik kindlicher Sprachstörungen. Folia phoniat. 21

Wendler, J., Rauhut, A.; Krueger, H.: Classification of voice qualities. J. Phonet. 14 (1986), 483-488

Wendler, J.; Seidner, W.: Stimmfunktion nach endolaryngealer Mikrochirurgie. Sprache-Stimme-Gehör 2 (1978), 105-107

Wendler, J.; Seidner, W.: Methoden und Ergebnisse der Phonochirurgie. Z. klin. Med. 46 (1991), 73-75

Wendler, J.; Seidner, W.; Rose, A.; Simon, B.; Ulbrich, H.: Zur praktischen Nomenklatur der funktionellen Dysphonien. Folia phoniat. 25 (1973), 30-38.

Wendler, J.; Doherty, E. T.; Hollien, H.: Voice classification by means of long-term speech spectra. Folia phoniat. 32 (1980), 51-60

Zehmisch, H.: Der wehrpflichtige Stotterer. Z. Ärztl. Fortb. 63 (1969) 516 - 518.

Zehmisch, H.: Er brachte Licht ins Dunkel – Zum Gedenken an J. N. Czermak anlässlich seines 100. Todestages am 16. September 1973. Z. Ärztl. Fortb. 67 (1972), 949-951

Zehmisch, H.: Hormonelle Dysphonie bei Frauen - meist iatrogen bedingt! Z. Ärztl. Fortb. 68 (1974), 19-21.

Zehmisch, H.: Die Gutzmanns. Proc. 16th Congr. IALP. Interlaken 1974. Basel: Karger 1976. S. 542-548.