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1.
Codas ; 32(4): e20190135, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32813819

RESUMO

PURPOSE: To evaluate the ability that in tune and out of tune individuals have to identify normal and deviated voice qualities and to compare it with their performance in auditory processing tests and perceptual judgment. METHOD: The study investigated 15 in tune and 15 out of tune individuals. Participants were matched for age and sex, were amateur choir singers, had normal hearing thresholds and normal vocal quality. All individuals underwent Pitch-matching scanning to be classified as in or out of tune. Next, they performed the Pitch Pattern Sequence (PPS) and the Duration Pattern Sequence (DPS) tests and the perceptual judgment of 36 voices plus 20% of repetition for reliability analysis. RESULTS: The out of tune individuals had worse performance in the PPS and DPS for both ears (p=0.002 RE; p=0.001 LE; p=0.009 DPS); no difference was observed in the perceptual judgment and the reliability (p=0.153). However, participants with normal PPS and DPS had better performance in the perceptual judgment and better reliability (p=0.033). Thus, individuals with disorders in temporal auditory processing skills have greater difficulty in the perceptual judgment and have lower intra-rater reliability, despite being in or out of tune. CONCLUSION: It can be observed that voice tone is not required to guarantee good perceptual judgment. However, temporal patterns and intra-rater reliability are essential to perceptually assess normal and altered voice qualities. Therefore, auditory training should be included in programs that aim to develop voice perceptual judgment abilities.


Assuntos
Transtornos da Percepção Auditiva/fisiopatologia , Transtornos da Percepção Auditiva/psicologia , Julgamento , Acústica da Fala , Qualidade da Voz , Percepção Auditiva , Estudos de Casos e Controles , Audição , Testes Auditivos , Humanos , Reprodutibilidade dos Testes
2.
Codas ; 32(3): e20180304, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32638826

RESUMO

PURPOSE: Verify the perception of popular and classical singers in relation to vocal symptoms and their possible relations regarding knowledge of health and vocal hygiene. METHOD: This study was composed of 242 singers, aged between 17 and 60, of both sexes. A total of 56 singers were selected, with 186 singers, divided into 104 Popular Singers Group (PSG) and 82 Classical Singers Group (CSG). All participants answered the questionnaire for identification and also vocal self-assessment, and two protocols were applied, namely: Brazilian validated version of Voice Symptom Scale - VoiSS (Escala de Sintomas Vocais - ESV) and Questionário de Saúde e Higiene Vocal (QSHV). RESULTS: The largest number of participants was female. The classical singers presented more time of singing class than the popular ones. Show hours of 1-2 hours was higher in the number of subjects responding to both groups of singers. Classical singers presented greater perception of vocal symptoms when compared to the popular ones for total and emotional scores of the Brazilian validated version of VoiSS. The popular and classical groups do not make any difference regarding health and vocal hygiene, even though the groups obtained values above the QSHV normality score. There was no correlation between knowledge about vocal health and hygiene and vocal symptoms in singers. CONCLUSION: Classical singers are more affected by vocal changes, especially women. The singers obtained a good degree of knowledge in vocal hygiene, not differing about the styles. The perception of vocal alteration in popular and classical singers seems to have no relation with the degree of health knowledge and vocal hygiene.


Assuntos
Higiene , Autoimagem , Canto , Distúrbios da Voz , Adolescente , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Qualidade da Voz , Adulto Jovem
3.
PLoS One ; 15(3): e0229960, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32160255

RESUMO

BACKGROUND/AIM: It is widely believed that 'creaky voice' ('creak', 'vocal fry', 'glottal fry') is increasingly prevalent among some English speakers, particularly among young American women. Motivated by the widespread and cross-disciplinary interest in the phenomenon, this paper offers a systematic review of peer-reviewed research (up to January 2019) on the prevalence of creaky voice in varieties of English. The review aimed to understand whose and what speech has been studied, how creaky voice prevalence has been measured, and what the findings collectively reveal. METHOD: Literature was located by searching four electronic databases (ProQuest, PubMed, SCOPUS, Web of Science) and the proceedings of two recurrent conferences ('ICPhS' and 'SST'). Studies were included if they reported the prevalence of creaky voice in naturalistic samples of English spoken by vocally-healthy speakers. Reference lists of included studies were cross-checked. RESULTS: Only ten studies meeting inclusion criteria were identified. All studies sampled a small number of speakers and/or short durations of speech. Nine were recent studies of American-English speakers, and many of these sampled young, female, college students. Across the ten studies, creaky voice was detected using three types of methods, and prevalence was calculated using five different formulae. The findings show that prevalence varies across groups, individuals, and contexts. However, the precise nature of this variability remains unclear due to the scarcity and methodological heterogeneity of the research. CONCLUSIONS: This paper illustrated the application of systematic literature review methods in sociophonetic research-a field in which such methods are not common. The review found that creaky voice prevalence in English is not well understood, and that widespread claims of its recent increase among young American women have not been empirically confirmed. A number of specific limitations in the existing research are highlighted, which may serve as a guide for future research design.


Assuntos
Percepção da Fala/fisiologia , Fala/fisiologia , Voz/fisiologia , Fatores Etários , Humanos , Idioma , Fonação/fisiologia , Fatores Sexuais , Acústica da Fala , Medida da Produção da Fala , Fatores de Tempo , Qualidade da Voz/fisiologia
4.
Codas ; 32(2): e20190121, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32215472

RESUMO

PURPOSE: To create a consensus version of a speech-language pathology (SLP) script to assess the expressiveness of voice professionals. METHODS: The process was divided into three stages: stage 1 included a survey of the literature and classification of the variables found in the instruments used; in steps 2 and 3, through teamwork, expert judges (focus groups I and II) created and adapted, along with the researcher, a consensus version of the expressiveness assessment script. RESULTS: The initial list presented to the judges contained 48 variables found in the literature: 11 related to emotional and interpretation aspects, 20 associated with oral expressiveness, three related to issues of verbal expressiveness, and 14 related to nonverbal expressiveness. In stage 2, the initial version of the script of the focus group I resulted in a document with 28 parameters, distributed in three thematic assessment groups: general aspects of communication, with three parameters; aspects related to oral expressiveness, with 16 parameters; aspects associated with body expressiveness, with nine parameters. In stage 3, after adequacy by focus group II, the consensus version also resulted in 28 parameters, distributed in two thematic groups. CONCLUSION: The consensus version of the SLP expressiveness assessment script for voice professionals was finalized with 28 parameters, distributed in two thematic axes: initial impact of communication, with six parameters; expressiveness, with 22 parameters.


Assuntos
Patologia da Fala e Linguagem/instrumentação , Qualidade da Voz/fisiologia , Consenso , Humanos , Estudos Prospectivos , Patologia da Fala e Linguagem/métodos , Voz/fisiologia
5.
Codas ; 32(4): e20190074, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32049106

RESUMO

PURPOSE: To verify and compare the immediate effects of the voiced oral high-frequency oscillation (VOHFO) technique and the phonation into a silicone resonance tube in the elderly self-perception of vocal and laryngeal symptoms and in their voice quality. METHODS: 14 elderly women, over 60 years old, performed the VOHFO and phonation into a resonance tube technique (35cm in length and 9mm in diameter) with one-week interval between both to avoid carry-over effect. Initially, all participants answered questions regarding the frequency and intensity of their vocal/laryngeal symptoms. Recordings of the sustained vowel /a/ and counting numbers were performed for posterior perceptual and acoustic analyses of the voice quality. The maximum phonation time (MPT) for /a/, /s/, /z/ and counting numbers were also obtained. After that, a draw lot established which technique (VOHFO or resonance tube) would be initially applied for three minutes. After the exercise performance the same procedures were carried out and the elderly women answered a self-assessment questionnaire about the effect of the techniques in her voice, larynx, breathing and articulation. Comparison pre and post each technique were analyzed using ANOVA, Wilcoxon and Mann-Whitney tests. The sensations after the techniques were assessed using the Chi-square test (p<0.05). RESULTS: The comparison of both techniques showed decrease in roughness and improvement in resonance for counting numbers after the resonance tube and same outcomes post VOHFO. There were no significant differences for the other analyzed variables between groups. CONCLUSION: The phonation into a resonance tube exercise improves the vocal quality of elderly women. In addition, both exercises are similar regarding self-perception of vocal / laryngeal symptoms and sensations post three minutes of the technique, suggesting that VOHFO can be safely applied in voice therapy for this population.


Assuntos
Laringe/fisiopatologia , Fonação/fisiologia , Acústica da Fala , Qualidade da Voz/fisiologia , Treinamento da Voz , Idoso , Envelhecimento/fisiologia , Feminino , Ventilação de Alta Frequência/métodos , Humanos , Julgamento , Doenças da Laringe/complicações , Pessoa de Meia-Idade , Autoimagem , Autorrelato , Patologia da Fala e Linguagem/métodos , Distúrbios da Voz/fisiopatologia , Distúrbios da Voz/psicologia
6.
Codas ; 32(4): e20190068, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32049104

RESUMO

PURPOSE: To describe the emission of upper high notes by professional sopranos by means of the auditory-perceptual evaluation of the singers' voices and self-reports. METHODS: Five professional sopranos performed an excerpt from a Bellini opera which involved the emission of an upper high note. The auditory-perceptual evaluation was carried out by three speech-language therapists and three singing teachers, who considered brightness, loudness, metal quality, vibrato, breathiness, and resonance on a visual-analytical scale, based on each singer's emission of high notes. After the recording, the singers were asked to answer a proprioceptive questionnaire on the physical sensations that they had as they emitted upper high notes. An inferential analysis of the data from the auditory-perceptual evaluation was conducted, and the singers' self-reports were summarized and then orthographically transcribed. RESULTS: In the auditory-perceptual analysis, the emission of upper high notes was characterized according to the presence of brightness, loudness, metal quality, vibrato, and anterior resonance, as perceived by speech-language therapists and singing teachers. In the proprioceptive report, all singers reported laryngeal elevation and a need to use respiratory support in order to emit upper high notes. CONCLUSION: Upper high notes are characterized by a bright vocal emission, enhanced loudness, with a metallic quality and vibrato, little or no breathiness, accompanied by a sensation of laryngeal elevation and a need for respiratory support.


Assuntos
Percepção Auditiva/fisiologia , Canto/fisiologia , Percepção da Fala/fisiologia , Voz/fisiologia , Adulto , Humanos , Laringe/fisiologia , Ocupações , Vibração , Distúrbios da Voz/fisiopatologia , Qualidade da Voz
7.
Artigo em Chinês | MEDLINE | ID: mdl-32086924

RESUMO

Objective:The aim of this study is to investigate the effect of CO2 laser cordectomy on the voice of early glottic carcinoma. Method:A retrospective analysis of 40 patients who underwent CO2 laser treatment early glottis preoperative clinical data of postoperative laryngeal cancer patients, patients with postoperative recurrence rate, survival rate, and the postoperative complications of patients with preoperative and postoperative laryngoscopy, voice disorders index(voice handicap index, VHI) simplified Chinese version(VHI 13) rating scale, affecting the stability sound quality postoperatively in patients with laryngeal cancer were discussed. Result:All patients underwent voice reexamination 8-97 months after surgery, and the survival rate was 100%, no local recurrence and no obvious postoperative complications. Compared with the healthy control group, there were statistically significant differences in the four indicators F0(fundamental frequency), Jitter(fundamental frequency perturbation), Shimmer(amplitude perturbation) and MPT(maximum pronunciation time), suggesting that CO2 laser surgery resulted in significant changes in acoustic parameters. Jitter and Shimmer indexes in the pre involved combined group were statistically significant different from those in the non involved combined group, suggesting that the sound quality of the pre involved combined group was worse in the postoperative stability period. The VHI score indicated that most patients with early glottic cancer were in severe voice disorder before operation and most were in moderate voice disorder after operation. Compared with the healthy control group, the VHI score and total score of the healthy control group were lower in terms of physiology, psychology and emotion. Compared with the healthy control group, the VHI score and physiology of the early glottic laryngeal cancer patients were lower in the early glottic laryngeal cancer patients before and after surgery, and they were statistically significant. Conclusion:CO2 laser surgery for early glottic cancer, the overall survival rate of patients, low recurrence rate, fewer complications, CO2 laser surgery led to significant changes in acoustic parameters, postoperative sound quality and whether the involvement of pre-associated factors; The total score of VHI and physiological score of early glottic carcinoma patients after CO2 laser operation were better than those before operation.


Assuntos
Neoplasias Laríngeas/cirurgia , Terapia a Laser , Lasers de Gás , Distúrbios da Voz/etiologia , Qualidade da Voz , Dióxido de Carbono , Glote/cirurgia , Humanos , Recidiva Local de Neoplasia , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do Tratamento
8.
Codas ; 32(2): e20180141, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32049096

RESUMO

PURPOSE: Describe the self-referred personal behavior profiles of university professors and verify the association of these profiles with the self-assessment of communicative aspects and vocal symptoms. METHODS: Study conducted with 334 professors at a public university who responded to an online questionnaire regarding voice use in teaching practice. Personal behavior profile classification was the response variable, which was divided into four types: pragmatic, analytical, expressive and affable. Explanatory variables were vocal self-perception, vocal resources, and communicative aspects. Descriptive data analysis was performed with application of the Pearson's Chi-squared and Fisher's Exact tests. RESULTS: University professors identified themselves more with the affable and expressive personal behavior profiles. Overall, professors presented good self-perception about vocal and communicative aspects, in addition to having reported few vocal symptoms. Profiles differed for some of the assessed variables, namely, pragmatic professors reported high speech velocity and sporadic eye contact; expressive professors demonstrated self-perception about their voice and strong voice intensity; those in the analytical profile self-reported negative perception about vocal quality, weak voice intensity, poor articulation and rapid speaking rate; the other professors mostly reported voice tiredness symptoms and difficulty projecting the voice. CONCLUSION: University professors identify themselves mostly with the affable and expressive profiles. Self-perception analysis of the personal behavior profile in university professors showed the influence of self-reported personality characteristics on communicative skills in the classroom.


Assuntos
Autoimagem , Autoavaliação , Medida da Produção da Fala/psicologia , Qualidade da Voz/fisiologia , Estudos Transversais , Docentes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Acústica da Fala , Inquéritos e Questionários , Comportamento Verbal/fisiologia , Distúrbios da Voz/classificação , Distúrbios da Voz/diagnóstico , Distúrbios da Voz/psicologia
9.
PLoS One ; 15(1): e0228464, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31999758

RESUMO

Glottal insufficiency due to vocal fold paralysis, paresis, or atrophy often leads to degraded voice quality. One of the primary surgical intervention procedures to treat glottal insufficiency is medialization laryngoplasty, in which an implant is inserted through a lateral window on the thyroid cartilage to medialize the vocal folds. While the goal of medialization is to modify the vocal fold structure to restore normal phonation, few studies have attempted to quantify such structural changes of the vocal folds. The goal of this study is to quantify the three-dimensional structural changes of the vocal folds due to implant insertion in medialization laryngoplasty, and evaluate its potential effect on voice production. Medialization laryngoplasty were performed in excised human larynges using implants of different stiffness. Magnetic resonance images of the larynges were obtained with and without implant insertion. The results showed that implant insertion significantly changed the original body-cover structure of the vocal folds, with the implant taking over the large space used to be occupied by the original body layer and the vocal fold being stretched into a thin layer wrapped around the implant. The medial-lateral dimension of the vocal fold was significantly reduced from about 4 mm to 1 mm, and the vocal fold was stretched in the coronal plane by about 70%. It is hypothesized that use of implants with stiffness comparable to that of the vocal folds is beneficial because the degree of medialization can be adjusted without much negative effects on phonation frequency, phonation threshold pressure, or vibration amplitude.


Assuntos
Laringoplastia/instrumentação , Laringe/cirurgia , Prega Vocal/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Cadáver , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Próteses e Implantes , Qualidade da Voz
10.
J Laryngol Otol ; 134(1): 68-73, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31918788

RESUMO

OBJECTIVE: To determine whether patients would have equivalent or improved outcomes when receiving non-surgical management versus surgical removal for vocal process granulomas. METHODS: A chart review was performed for 53 adults with vocal process granulomas. All patients received baseline anti-reflux treatment consisting of twice-daily proton pump inhibitors and vocal hygiene education. Further treatment approaches were divided into non-surgical (i.e. inhaled corticosteroids, voice therapy, botulinum toxin injections) and surgical groups. Subjective parameters (Voice Handicap Index 10 and Reflux Symptom Index) and outcomes were tabulated and statistically compared. Cause of granuloma was also analysed to determine if this influenced outcomes. RESULTS: Of 53 patients, 47 (89 per cent) experienced reduction in granuloma size, while 37 (70 per cent) experienced complete resolution. The rate of complete granuloma resolution after initial treatment strategy alone was significantly higher in non-surgical compared to surgical patients (67 and 30 per cent, respectively; p = 0.039). No difference in outcome was seen between iatrogenic and idiopathic granulomas. CONCLUSION: Non-surgical patients were more likely to experience initial treatment success than those who underwent surgical removal. Continued emphasis should be placed on conservative treatment options prior to surgery for patients with this condition.


Assuntos
Granuloma/terapia , Laringite/terapia , Inibidores da Bomba de Prótons/uso terapêutico , Prega Vocal/fisiopatologia , Adulto , Idoso , Terapia Combinada , Gerenciamento Clínico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos , Inibidores da Bomba de Prótons/farmacologia , Resultado do Tratamento , Prega Vocal/efeitos dos fármacos , Qualidade da Voz/efeitos dos fármacos , Treinamento da Voz
11.
Vasc Endovascular Surg ; 54(3): 288-291, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31896319

RESUMO

We present a case of an 87-year-old female with new-onset hoarseness of unclear etiology. Imaging demonstrated a penetrating aortic ulcer (PAU) in the proximal descending thoracic aorta with an associated pseudoaneurysm that enlarged to a depth of 32 mm over 2 years. This patient was diagnosed with hoarseness being secondary to left recurrent laryngeal nerve (LRLN) palsy, a variant of Ortner syndrome. Patient was treated with endovascular stent-grafting successfully covering of the PAU and pseudoaneurysm with zone 3 proximal landing zone. The patient had moderate improvement in hoarseness after 1 year of follow-up. Endovascular repair is indicated for symptomatic patients with PAUs complicated by enlarging pseudoaneurysms or rupture. Endovascular treatment is effective with low procedural morbidity and mortality. In this case, the PAU and associated pseudoaneurysm at the level of the ligamentum arteriosum caused compression on the LRLN, resulting in a nerve palsy and hoarseness. This case highlights the importance of vascular imaging for patients presenting with unclear etiology of hoarseness or other signs of LRLN palsy. Therefore, aortic arch abnormalities, a variant of Ortner syndrome, even though rare, should be on the differential diagnosis of new onset hoarseness.


Assuntos
Falso Aneurisma/complicações , Aneurisma da Aorta Torácica/complicações , Rouquidão/etiologia , Úlcera/complicações , Paralisia das Pregas Vocais/etiologia , Idoso de 80 Anos ou mais , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular , Procedimentos Endovasculares , Feminino , Rouquidão/diagnóstico , Rouquidão/fisiopatologia , Humanos , Recuperação de Função Fisiológica , Resultado do Tratamento , Úlcera/diagnóstico por imagem , Úlcera/cirurgia , Paralisia das Pregas Vocais/diagnóstico por imagem , Paralisia das Pregas Vocais/fisiopatologia , Qualidade da Voz
12.
Medicine (Baltimore) ; 99(1): e18579, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31895805

RESUMO

The aim of this study was to compare major voice indicators in different sub-categories, the outcome of lipoinjection for patients might be refined and some voice prognostic factors could be more particularized in specific sub-groups. This is an observational study, and sub-grouped UVFP patients into 3 categories: male vs female, BMI ≥ 24 vs BMI < 24, Age ≥ 60 vs Age < 60 for more detailed exploring whether sub-categories affected voice diagnostic and prognostic parameters. Patients' voice data is recorded before and after the autologous fat injection laryngoplasty by a multidimensional voice program. Overall, 73 patients' voice performance were improved 12 months later by vocal fold lipoinjection. In the comparison of the male with female revealed female obtained better Jita than male by surgery (Female: 174.50 ±â€Š100.58 Hz; Male: 294.82 ±â€Š253.65 Hz; P < .05). BMI ≥ 24 vs BMI < 24 showed no statistical difference. Patients aged under 60 demonstrated better Highest F0, lowest F0, NHR and ShdB than elder ones 12 months after receiving vocal fold lipoinjection. Thus, Noise-to-harmonics ratio (NHR), voice turbulence index (VTI), and ShdB (Absolute shimmer, dB) may be the major post-operative evaluating markers of patients' age under 60. Voice parameters showed no significant correlation with BMI. Female patients performed lower Jita (Absolute jitter, µsec) than male patients 1 year after receiving treatment. The experimental results in this study showed UVFP patients' gender and age may stand as significant categories on analyzing clinical voice prognostic indicators, ShdB and Jita of autologous injection laryngoplasty.


Assuntos
Tecido Adiposo/transplante , Laringoplastia/métodos , Complicações Pós-Operatórias/cirurgia , Paralisia das Pregas Vocais/cirurgia , Adulto , Idoso , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Glândula Tireoide/cirurgia , Transplante Autólogo , Paralisia das Pregas Vocais/etiologia , Qualidade da Voz
13.
HNO ; 68(1): 48-54, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31754731

RESUMO

BACKGROUND: In clinical routine, vocal fatigue is a common symptom in patients with dysphonia. OBJECTIVE: The aim of this study was to conduct a transcultural translation of the Vocal Fatigue Index (VFI), a standardized subjective questionnaire. Furthermore, pretesting and prevalidation were performed in 20 subjects, with comparison to the Voice Handicap Index (VHI­9i) and the Vocal Tract Discomfort Scale (VTD). MATERIALS AND METHODS: The translation, content review, and pretest of the German Vocal Fatigue Index (VFI-D) was divided into four sections: 1. transcultural translation, 2. expert voting on comprehensibility, 3. test of comprehensibility through cognitive interviews in 15 participants, 4. pretest of the VFI­D with cross validation compared to VHI­9i and VTD in 20 subjects. This process corresponds to current standards for transcultural translation and adaptation of questionnaires. RESULTS: According to expert voting and cognitive testing, the VFI­D is correct and comprehensible (intercoder reliability κ = 0.66). The factor analysis revealed three distinguishable parts: VFI­D part 1 correlates strongly with VHI­9i and VTD, VFI­D part 2 with VTD only (rho ≈ 0.800 each), and VFI­D part 3 correlates only weakly with VHI­9i and VTD (rho ≈ 0.585). Thus, convergence and divergence validity are proven. CONCLUSION: The first German version of the VFI­D might be a base for further research on symptoms, causes, and treatment options in vocal fatigue. Particularly patients in voice-intensive professions may benefit.


Assuntos
Disfonia , Distúrbios da Voz , Qualidade da Voz , Disfonia/complicações , Disfonia/diagnóstico , Humanos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Inquéritos e Questionários , Distúrbios da Voz/etiologia
14.
Ann Otol Rhinol Laryngol ; 129(4): 355-360, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31735062

RESUMO

OBJECTIVES: Recurrent laryngeal nerve (RLN) injury may be a consequence of surgical procedures of the skull base, neck, and chest, with adverse consequences to function and quality of life. Laryngeal reinnervation offers a potentially stable improvement in vocal fold position and tone. The classic donor nerve is the ansa cervicalis, but is not always available due to damage or sacrifice during previous neck surgeries. Our objective was to introduce the nerve to the thyrohyoid (TH) muscle as an alternate donor nerve for reinnervation, which has not previously been described. METHODS: Case series of two patients using the TH nerve for laryngeal reinnervation after RLN injury, with description of surgical harvest. RESULTS: Follow-up results are available for 10 months (one patient) and 3 years (one patient) demonstrating both subjective and objective improvement in function. GRBAS scores were reduced. Maximal phonation time was improved. Patient rating of voice was stable or improved postoperatively. One patient described significant preoperative dyspnea which was significantly improved postoperatively, from a score of 24 to 10 out of 40 on the dyspnea handicap index. VHI was improved in one patient, but scores elevated in the other, despite a change from "moderately severe impairment" to "normal voice" subjectively. Neither patient experienced significant complications from the procedure. CONCLUSION: Laryngeal reinnervation procedures provide good outcomes in pediatric patients. When ansa cervicalis is not available as a donor nerve, the nerve to TH provides a reasonable alternative.


Assuntos
Complicações Intraoperatórias , Músculos Laríngeos , Transferência de Nervo/métodos , Qualidade de Vida , Traumatismos do Nervo Laríngeo Recorrente , Câncer Papilífero da Tireoide/cirurgia , Glândula Tireoide/inervação , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/efeitos adversos , Adolescente , Feminino , Humanos , Complicações Intraoperatórias/fisiopatologia , Complicações Intraoperatórias/psicologia , Músculos Laríngeos/inervação , Músculos Laríngeos/fisiopatologia , Laringoscopia/métodos , Regeneração Nervosa , Nervo Laríngeo Recorrente , Traumatismos do Nervo Laríngeo Recorrente/fisiopatologia , Traumatismos do Nervo Laríngeo Recorrente/psicologia , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia/métodos , Resultado do Tratamento , Qualidade da Voz
15.
Ann Otol Rhinol Laryngol ; 129(4): 333-339, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31731878

RESUMO

OBJECTIVES: Hearing loss has been implicated in dysphonia secondary to voice misuse, although the data supporting this claim are scant. Determining the prevalence of hearing loss in patients with dysphonia and correlating it with self-perception of vocal handicap may help clarify the value of audiometry in evaluation of patients with dysphonia. METHODS: This is a retrospective chart review of all new voice patients (n = 405) presenting with dysphonia to the primary investigator between 2015 and 2018. Each new patient routinely undergoes audiometric and voice objective analyses. Main outcomes measured include prevalence, severity of hearing loss, and voice handicap index-10 (VHI-10). RESULTS: Of the 405 subjects reviewed, mean age was 49.0 years (SD = 17.4). 60.7% of subjects were female and 39.3% male. Patients with hearing loss defined as >25 dB in worse ear with pure tone average (PTA) thresholds at 0.5, 1, 2, and 3 kHz (PTA-S) accounted for 18% of the total cohort. The prevalence of previously undiagnosed hearing loss in this cohort was 13.1% (53 of 405 subjects). Of these subjects, 62.3% (33 subjects) reported no perception of hearing loss while 37.7% (20 subjects) suspected they had some hearing loss, yet never sought evaluation. Only increased PTA-S, speech discrimination, Reflux Symptom Index, and female gender demonstrated a significant relationship with VHI-10 when analyzed with multivariate linear regression analysis. CONCLUSIONS: The prevalence of hearing loss in patients presenting with dysphonia in this cohort is similar to normative population data. This study has also demonstrated that the majority of these patients did not perceive any hearing loss. The reasons behind this may be a result of or associated with the patients' dysphonia. Furthermore, clinicians should consider performing audiometric evaluation in patients with abnormal VHI-10 scores in the appropriate clinical context.


Assuntos
Audiometria/métodos , Disfonia , Perda Auditiva , Percepção da Fala , Qualidade da Voz , Avaliação da Deficiência , Disfonia/diagnóstico , Disfonia/epidemiologia , Disfonia/fisiopatologia , Disfonia/psicologia , Feminino , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Estudos Retrospectivos , Medição de Risco , Autoimagem , Índice de Gravidade de Doença , Estados Unidos/epidemiologia
17.
Surgery ; 167(1): 129-136, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31526583

RESUMO

BACKGROUND: Voice disorders are frequent after thyroidectomy. We report the long-term voice quality outcomes after thyroidectomy using the voice handicap index self-questionnaire. METHODS: Eight hundred patients who underwent total thyroidectomy between 2014 and 2017 in 7 French hospitals were prospectively included. All patients filled in voice handicap index questionnaires, preoperatively and 2 and 6 months after surgery. RESULTS: Median (range) voice handicap index scores were significantly increased at month 2 (4 [0; 108]) compared to preoperative values (2 [0; 76]) and were unchanged at month 6 (2 [2; 92]). Clinically significant voice impairment (voice handicap index score difference ≥18 points) was reported in 19.7% at month 2 and 13% at month 6. Thirty-seven (4.6%) had postoperative vocal cord palsy. In patients with vocal cord palsy compared to those without, median voice handicap index scores were increased at month 2 (14 [0; 107] vs 4 [0; 108]; P = .0039), but not at month 6 (5 [0; 92] vs 2 [0; 87]; P = .0702). Clinically significant impairment was reported in 38% vs 19% at month 2 (P = .010), and in 19% vs 13% at month 6 (P = .310). Thyroid weight, postoperative hypocalcemia, vocal cord palsy, and absence of intraoperative neuromonitoring utilization were associated with an increased risk of clinically significant self-perceived voice impairment at month 2. CONCLUSION: Thyroidectomy impairs patients' voice quality perception in patients with and without vocal cord palsy.


Assuntos
Complicações Pós-Operatórias/diagnóstico , Autoavaliação , Tireoidectomia/efeitos adversos , Paralisia das Pregas Vocais/diagnóstico , Distúrbios da Voz/diagnóstico , Adulto , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/psicologia , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários/estatística & dados numéricos , Paralisia das Pregas Vocais/etiologia , Paralisia das Pregas Vocais/psicologia , Distúrbios da Voz/etiologia , Distúrbios da Voz/psicologia , Qualidade da Voz
18.
Codas ; 32(1): e20180233, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31851210

RESUMO

PURPOSE: To characterize and to compare the perception of vocal fatigue in professors at the beginning and at the end of the school year. METHODS: Observational, analytical, prospective cohort study was carried out. A total of 115 professors participated with a mean age of 40 years old, 71 women and 44 men, employees of 28 higher education institutions in the south and southeast regions of Brazil. All answered to the Vocal Fatigue Index (VFI) at the beginning (February or March) and at the end (October or November) of the Brazilian school year. The VFI results for both assessed moments were statistically compared (p<0.05). RESULTS: The professors' mean scores obtained in the factors of tiredness of voice and avoidance of voice use (p<0.001) and improvement of symptoms with rest (p=0.001) increased at the end of the school year. CONCLUSION: Professors reported higher perception of vocal fatigue at the end of the school year, which influenced the avoidance of voice use and improvement of symptoms with the rest.


Assuntos
Doenças Profissionais/diagnóstico , Distúrbios da Voz/diagnóstico , Qualidade da Voz , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador , Estudos Prospectivos , Professores Escolares , Instituições Acadêmicas , Autoimagem , Inquéritos e Questionários
19.
Codas ; 32(2): e20180242, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31855224

RESUMO

PURPOSE: To identify the parameters that influences the decision of singing teachers to seek speech-language pathology (SLP) assistance for their students. METHODS: The study sample comprised 48 popular-music singing teachers, male and female, aged 37.96 years on average. The participants responded to a 10 closed-question questionnaire prepared by the researchers via the SurveyMonkey platform. The questions referred to the reasons why singing teachers seek SLP assistance, as well as to the knowledge of these teachers regarding chronic hoarseness as a risk symptom to identify other lesions in the larynx. RESULTS: Singing teachers seek SLP assistance for their students in the presence of hoarseness complaints and impaired speech sound articulation. The singing teachers assessed did not consider vocal tiredness complaint as a determining factor for referral to SLP evaluation. Most study participants were not aware that a hoarseness complaint for over 15 days can be indicative of larynx tumor. There was no influence of the variables age and time of professional experience in the referral to SLP assistance. CONCLUSION: Most of the singing teachers who participated in this study sought SLP assistance for their students when they presented hoarseness complaints and impaired speech sound articulation.


Assuntos
Canto , Distúrbios da Voz/diagnóstico , Qualidade da Voz , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Percepção da Fala , Patologia da Fala e Linguagem , Estudantes , Inquéritos e Questionários , Distúrbios da Voz/terapia
20.
Support Care Cancer ; 28(1): 131-140, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30993449

RESUMO

OBJECTIVES: To investigate among patients treated with a total laryngectomy (TL) (1) Internet-use and Internet use to search for information on health and cancer (content); (2) which patients are most likely to use the Internet in general, for health-related and cancer-related purposes; (3) which other types of eHealth (community, communication, care) are used; and (4) preferences towards future use. METHODS: Patient members of the Dutch TL patient society were asked to complete a questionnaire on Internet use, health-related and cancer-related Internet use, types of eHealth, preferences towards future use, socio-demographics, clinical factors, and quality of life (QOL). Factors associated with Internet use and health-related and cancer-related Internet use were investigated using stepwise logistic regression analysis. RESULTS: In total, 279 TL patients participated, of whom 68% used the Internet. Of these, 63% used the Internet to search for information on health and 49% on cancer. Younger and higher educated TL patients and those with better QOL used the Internet more often. Patients with worse QOL searched more often for health-related information. Younger patients and those with shorter time since TL searched more often for cancer-related information. The current use of eHealth for communication, community, and care purposes among Internet users was limited (range, 2 to 15%). Many were interested in using these types of eHealth in the future (range, 21 to 72%). CONCLUSION: The majority used the Internet, especially to search for information on health and cancer, but only few for communication, community, or care purposes. Many were interested in future use.


Assuntos
Comportamento de Busca de Informação , Internet/estatística & dados numéricos , Neoplasias Laríngeas , Laringectomia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Comunicação , Estudos Transversais , Feminino , Humanos , Neoplasias Laríngeas/epidemiologia , Neoplasias Laríngeas/psicologia , Neoplasias Laríngeas/terapia , Laringectomia/reabilitação , Laringectomia/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Qualidade de Vida , Apoio Social , Inquéritos e Questionários , Telemedicina/estatística & dados numéricos , Qualidade da Voz
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