Description:

This keynote will highlight the central role of feedback in voice and speech production, focusing on how auditory and proprioceptive signals regulate aerodynamic events, tissue vibration, and resonance. Traditional linear and non-linear acoustic models often neglect these sensorimotor pathways and fall short in explaining physiological and clinical phenomena. In contrast, voice and speech are governed by both aerodynamic and structural dynamics and feedback loops that refine and stabilize production—a perspective advanced by the recently proposed Non-Radiating Waves Theory (NRWT). Clinically, feedback mechanisms provide critical insight for diagnosis, guide surgical decision-making, and support rehabilitation. Special emphasis will be placed on biofeedback as a therapeutic strategy, bridging physiological understanding with practical applications in speech and voice therapy.

Outcome Objectives:

At the conclusion of this session, participants are expected to be able to:

·         Analyze auditory and proprioceptive feedback mechanisms in physiological voice regulation,

·         Explain the contributions of feedback mechanisms to the diagnosis and clinical management of resonance and voice disorders,

·         Implement biofeedback techniques in the therapeutic management of speech and voice.

Structure of the Session:

·         Introduction – Feedback as a fundamental regulatory principle in voice production

·         Physiological Background – Aerodynamic and structural bases with emphasis on recent physiological frameworks of voice production

·         Clinical Applications – Diagnostic perspectives and surgical considerations in resonance and voice disorders

·         Therapeutic Approaches – Biofeedback strategies in speech and voice therapy

·         Discussion

Background:

·         Kılıç, M.A. "The Non-Radiating Waves Theory in Voice Production: A Paradigm Shift." VoiceIstanbul 2025, Conference Presentation, İstanbul, May 2025.

·         am Zehnhoff-Dinnesen, A. et al. (2025). Rehabilitation and Prognosis of Dysglossia, Resonance Disorders and Velopharyngeal Insufficiency. In: am Zehnhoff-Dinnesen, A., Sopko, J., Monfrais - Pfauwadel, M..C., Neumann, K. (eds) Phoniatrics II. European Manual of Medicine. Springer, Cham. https://doi.org/10.1007/978-3-031-25175-7_5

·         Kılıç, MA. Konuşma anatomisi ve fizyolojisi. F. Öz, H. Coşkun, S. Şirin (editör) Her Yönüyle Larengoloji. Ankara: Ankara Nobel Tıp Kitabevleri; 2021. p. 46-62.

·         Kılıç, M.A. “Ses terapisi olarak biyolojik geribildirim yöntemi”, Turkiye Klinikleri J E.N.T.-Special Topics, 6(2), 41-45 (2013).

·         Kılıç, M.A., İ. Yıldırım, E. Okur, F. Öğüt, B. Şerbetçioğlu, “The effect of stimulus duration on perception of Turkish vowels in normal-hearing and hearing-impaired children”, Int. J. Audiol., 45, 675-680 (2006).

·         Kılıç, M.A., “Larenksin fonksiyonel anatomisi ve ses fizyolojisi”, Türkiye Klinikleri KBB Dergisi (Ses Bozuklukları Özel Sayısı), 2, 1-8 (2002).

Description:

Nasal resonance disorders are not limited to cleft palate and its surgical management. In everyday otorhinolaryngology practice, they often emerge due to tonsillar hypertrophy, adenoid vegetation, and as complications of tonsillectomy, adenoidectomy or OSA surgery. In addition, rhinoplasty, septoplasty, and other common nasal surgeries or pathologies may result in altered resonance.

Because of this broad etiological spectrum, patients with resonance changes should be assessed comprehensively by an ENT specialist. Evaluation combining perceptual, endoscopic, acoustic, and aerodynamic methods provides the basis for accurate diagnosis. Surgical treatment of the underlying anatomical causes should be complemented with postoperative speech therapy to optimize functional outcomes.

This round table will:

·         Emphasize that patients with resonance disorders should be evaluated by an ENT specialist with expertise across subspecialties such as phoniatrics, rhinology and sleep surgery.

·         Discuss current surgical options and their implications for resonance outcomes.

Significance:

For ENT specialists, resonance disorders remain a frequent and clinically significant challenge. This session will update knowledge, encourage discussion across subspecialties such as phoniatrics, rhinology, and sleep surgery, and highlight integrated approaches that improve patient outcomes.