RESUMO
OBJECTIVE: To analyze comparatively the speaking fundamental frequency (F0) between women at menacme and women in the climacterium taking or not hormonal replacement therapy. METHODS: A controlled transverse study was conducted on 45 women divided into three groups of 15 women each: Group A (women aged 20-40 years with regular menstrual cycles taking no hormonal contraceptives), Group B (women aged 45-60 years with a duration of menopause of at least 2 years taking 1mg estradiol valerate +90 microg norgestimate per day in a continuous treatment scheme lasting at least 6 months), and Group C (women aged 45-60 years with a duration of menopause of at least 2 years taking no HRT for at least 6 months). The mean age for Groups A, B and C was 30.3, 54.5 and 56.5 years, respectively. The groups were analyzed comparatively regarding F0 values for the sustained vowels /e/ and /i/. RESULTS: Mean F0 for the sustained vowels /e/ and /i/ were 215.97 and 229.89 Hz, 206.21 and 221.79 Hz, 200.71 and 212.79 Hz for Groups A, B and C, respectively, with no significant differences between groups. CONCLUSIONS: Although there is evidence of a probable modulating effect of sex steroids on the larynx, in the present study no significant differences in speaking voice were observed regarding menopause or the use of HRT. The absence of such differences observed in F0 does not necessarily mean that there is no difference in vocal quality between these groups since F0 represents only a vocal parameter.
Assuntos
Estradiol/análogos & derivados , Estrogênios Conjugados (USP)/farmacologia , Menopausa/fisiologia , Acústica da Fala , Voz/fisiologia , Adulto , Análise de Variância , Estudos de Casos e Controles , Estradiol/sangue , Estradiol/farmacologia , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Laringoscopia/métodos , Laringe/efeitos dos fármacos , Laringe/fisiologia , Hormônio Luteinizante/sangue , Pessoa de Meia-Idade , Análise de Regressão , Testosterona/sangue , Voz/efeitos dos fármacosRESUMO
BACKGROUND: After laryngectomy for treatment of pharyngeal/laryngeal carcinomas the patients may be rehabilitated, for oral communication, with the esophageal speech. AIM: To study the intra-esophageal pressure during the esophageal speech. PATIENTS AND METHODS: It was measured the intra-esophageal pressure in 25 laryngectomized patients aged 40 to 70 years (median 57 years), 10 rehabilitated with esophageal speech and 15 unable to do so. The manometric method with continuous perfusion was used. The esophageal pressures was measured 3 to 5 cm below the upper esophageal sphincter when the patients tried to speak the vowel "a". Sometimes the air swallowed went to the stomach, with a peristaltic or simultaneous contraction in the esophageal body. RESULTS: During the attempt of esophageal speech the intra-esophageal pressure was higher in patients able to have esophageal speech (26.4 +/- 10.1 mm Hg, mean +/- SD) than in patients unable to do so (13.7 +/- 7.2 mm Hg). The esophageal contraction after a swallow of air was also higher in patients with esophageal speech (45.3 +/- 8.6 mm Hg) than in patients unable to do so (33.8 +/- 13.1 mm Hg). CONCLUSION: Laryngectomized patients rehabilitated with esophageal speech has a higher intra-esophageal pressure during speech than patients unable to do so, what may be consequence of the capacity to retain air inside the esophagus.