[The Hamburg concept for the treatment of functional dysphonia in patients with speech occupations (pedagogy) from the holistic viewpoint].

Literature on functional voice disorders, on their etiopathogenetic criteria linked in a complex way, on the multifaceted aspects of the symptoms, and on the varieties, which arise out of influences during the long-term course of the disease has reached a considerable volume. In relation to this fact, the description of therapeutic methods is thin and there is only sparse attention given to quantitative facts, such as intensity and duration of therapy and the possible influences of patients' professional field on the therapeutic course. However, there is general agreement that qualitative features and quantitative volume of therapy should be enlarged under the holistic aspect of an adequate therapy of voice function, depending on individual necessities. Under such a holistic aspect, two fundamental ways of therapy are possible and both ways have advantages and disadvantages, which originate from principal differences: out-patient therapy and in-patient therapy. The Hamburg-Concepts of out-patient therapy of professional voice disorders which were created, tested, corrected and in a long-lasting process finally structured in terms of operational diagrams are discussed in this paper under different points of view: the precondition is a complete evaluation of all influencing factors in an interdisciplinary process. In closing, a new program of cooperation between the institution for in-patient voice therapy in Werscherberg/Osnabrück and the Hamburg Team is mentioned, a program which, though very complex and risky, is intended to close the gap between in-patient and out-patient therapy.