Cepstral Peak Prominence Smoothed - CPPS and Acoustic Voice Quality Index - AVQI in healthy and altered children's voices: comparation, relationship with auditory-perceptual judgment and cut-off points. / Cepstral Peak Prominence Smoothed - CPPS e Acoustic Voice Quality Index - AVQI em vozes infantis saudáveis e alteradas: comparação, relação com julgamento perceptivo-auditivo e pontos de corte.

PURPOSE: To compare the acoustic measurements of Cepstral Peak Prominence Smoothed (CPPS) and Acoustic Voice Quality Index (AVQI) of children with normal and altered voices, to relationship with auditory-perceptual judgment (APJ) and to establish cut-off points. METHODS: Vocal recordings of the sustained vowel and number counting tasks of 185 children were selected from a database and submitted to acoustic analysis with extraction of CPPS and AVQI measurements, and to APJ. The APJ was performed individually for each task, classified as normal or altered, and for the tasks together defining whether the child would pass or fail in a situation of vocal screening. RESULTS: Children with altered APJ and who failed the screening had lower CPPS values and higher AVQI values, than those with normal APJ and who passed the screening. The APJ of the sustained vowel task was related to CPPS and AVQI, and APJ of the number counting task was related only to AVQI and CPPS numbers. The cut-off points that differentiate children with and without vocal deviation are 14.07 for the vowel CPPS, 7.62 for the CPPS numbers and 2.01 for the AVQI. CONCLUSION: Children with altered voices, have higher AVQI values and lower CPPS values, when detected in children with voices within the normal range. The acoustic measurements were related to the auditory perceptual judgment of vocal quality in the sustained vowel task, however, the number counting task was related only to the AVQI and CPPS. The cut-off points that differentiate children with and without vocal deviation are 14.07 for the CPPS vowel, 7.62 for the CPPS numbers and 2.01 for the AVQI. The three measures were similar in identifying voices without deviation and dysphonic voices.

OBJETIVO: Comparar as medidas acústicas de Cepstral Peak Prominence Smoothed (CPPS) e Acoustic Voice Quality Index (AVQI) de crianças com vozes normais e alteradas, relacionar com o julgamento perceptivo-auditivo (JPA) da voz e estabelecer pontos de corte. MÉTODO: Gravações vocais das tarefas de vogal sustentada e contagem de números de 185 crianças foram selecionadas em um banco de dados e submetidas a análise acústica com extração das medidas de CPPS e AVQI, e ao JPA. O JPA foi realizado individualmente para cada tarefa e as amostras foram classificadas posteriormente como normal ou alterada, e para as tarefas em conjunto definindo-se se a criança passaria ou falharia em uma situação de triagem vocal. RESULTADOS: Crianças com JPA alterado e que falharam na triagem apresentaram valores menores de CPPS e maiores de AVQI, do que as com JPA normal e que passaram na triagem. O JPA da tarefa de vogal sustentada se relacionou ao CPPS e AVQI, e da tarefa de contagem de números relacionou-se apenas ao AVQI e CPPS números. Os pontos de corte que diferenciam crianças com e sem desvio vocal são 14,07 para o CPPS vogal, 7,62 para o CPPS números e 2,01 para o AVQI. CONCLUSÃO: Crianças com JPA alterado apresentaram maiores valores de AVQI e menores valores de CPPs. O JPA da tarefa de vogal previu todas as medidas acústicas, porém, de contagem previu apenas as medidas extraídas dela. As três medidas foram semelhantes na identificação de vozes sem desvio e vozes disfônicas.

Immediate effect of inspiratory exercise with exerciser and respiratory encourager in women without vocal complaints. / Efeito imediato de exercício inspiratório com exercitador e incentivador respiratório em mulheres sem queixas vocais.

PURPOSE: To evaluate the immediate effect of the inspiratory exercise with a booster and a respiratory exerciser on the voice of women without vocal complaints. METHODS: 25 women with no vocal complaints, between 18 and 34 years old, with a score of 1 on the Vocal Disorder Screening Index (ITDV) participated. Data collection was performed before and after performing the inspiratory exercise and consisted of recording the sustained vowel /a/, connected speech and maximum phonatory times (MPT) of vowels, fricative phonemes and counting numbers. In the auditory-perceptual judgment, the Vocal Deviation Scale (VSD) was used to verify the general degree of vocal deviation. Acoustic evaluation was performed using the PRAAT software and the parameters fundamental frequency (f0), jitter, shimmer, harmonium-to-noise ratio (HNR), Cepstral Peak Prominence Smoothed (CPPS), Acoustic Voice Quality Index (AVQI) and Acoustic Breathiness Index (ABI). To measure the aerodynamic measurements, the time of each emission was extracted in the Audacity program. Data were statistically analyzed using the Statistica for Windows software and normality was tested using the Shapiro-Wilk test. To compare the results, Student's and Wilcoxon's t tests were applied, adopting a significance level of 5%. RESULTS: There were no significant differences between the results of the JPA and the acoustic measures, in the pre and post inspiratory exercise moments. As for the aerodynamic measures, it was possible to observe a significant increase in the value of the TMF /s/ (p=0.008). CONCLUSION: There was no change in vocal quality after the inspiratory exercise with stimulator and respiratory exerciser, but an increase in the MPT of the phoneme /s/ was observed after the exercise.

OBJETIVO: Avaliar o efeito imediato do exercício inspiratório com incentivador e exercitador respiratório na voz de mulheres sem queixas vocais. MÉTODO: Participaram 25 mulheres sem queixas vocais, entre 18 e 34 anos, com pontuação 1 no Índice de Triagem para Distúrbio Vocal (ITDV). A coleta de dados foi realizada nos momentos antes e após realização de exercício inspiratório e consistiu na gravação de vogal sustentada /a/, fala encadeada e tempos máximos fonatórios (TMF) de vogais, fonemas fricativos e contagem de números. No julgamento perceptivo-auditivo foi utilizada a Escala de Desvio Vocal (EDV) para verificar o grau geral do desvio vocal. Avaliação acústica foi feita no software PRAAT e foram extraídos os parâmetros frequência fundamental (f0), jitter, shimmer, proporção harmônico -ruído (HNR), Cepstral Peak Prominence Smoothed (CPPS), Acoustic Voice Quality Index (AVQI) e Acoustic Breathiness Index (ABI). Para mensuração das medidas aerodinâmicas, o tempo de emissão foi extraído no programa Audacity. Para comparar os resultados utilizou-se o teste paramétrico t de Student para amostras dependentes na análise das variáveis com distribuição normal e o teste de Wilcoxon para variáveis com distribuição não normal. RESULTADOS: Não houve diferenças entre os resultados do JPA e das medidas acústicas, nos momentos pré e pós exercício inspiratório. Quanto às medidas aerodinâmicas foi possível observar aumento significativo no valor do TMF /s/ (p=0,008). CONCLUSÃO: Não houve modificação na qualidade vocal após o exercício inspiratório com incentivador e exercitador respiratório, porém foi observado aumento do TMF do fonema /s/ após a realização do exercício.

Efeito imediato de exercício inspiratório com exercitador e incentivador respiratório em mulheres sem queixas vocais / Immediate effect of inspiratory exercise with exerciser and respiratory encourager in women without vocal complaints

RESUMO Objetivo Avaliar o efeito imediato do exercício inspiratório com incentivador e exercitador respiratório na voz de mulheres sem queixas vocais. Método Participaram 25 mulheres sem queixas vocais, entre 18 e 34 anos, com pontuação 1 no Índice de Triagem para Distúrbio Vocal (ITDV). A coleta de dados foi realizada nos momentos antes e após realização de exercício inspiratório e consistiu na gravação de vogal sustentada /a/, fala encadeada e tempos máximos fonatórios (TMF) de vogais, fonemas fricativos e contagem de números. No julgamento perceptivo-auditivo foi utilizada a Escala de Desvio Vocal (EDV) para verificar o grau geral do desvio vocal. Avaliação acústica foi feita no software PRAAT e foram extraídos os parâmetros frequência fundamental (f0), jitter, shimmer, proporção harmônico -ruído (HNR), Cepstral Peak Prominence Smoothed (CPPS), Acoustic Voice Quality Index (AVQI) e Acoustic Breathiness Index (ABI). Para mensuração das medidas aerodinâmicas, o tempo de emissão foi extraído no programa Audacity. Para comparar os resultados utilizou-se o teste paramétrico t de Student para amostras dependentes na análise das variáveis com distribuição normal e o teste de Wilcoxon para variáveis com distribuição não normal. Resultados Não houve diferenças entre os resultados do JPA e das medidas acústicas, nos momentos pré e pós exercício inspiratório. Quanto às medidas aerodinâmicas foi possível observar aumento significativo no valor do TMF /s/ (p=0,008). Conclusão Não houve modificação na qualidade vocal após o exercício inspiratório com incentivador e exercitador respiratório, porém foi observado aumento do TMF do fonema /s/ após a realização do exercício.

ABSTRACT Purpose To evaluate the immediate effect of the inspiratory exercise with a booster and a respiratory exerciser on the voice of women without vocal complaints. Methods 25 women with no vocal complaints, between 18 and 34 years old, with a score of 1 on the Vocal Disorder Screening Index (ITDV) participated. Data collection was performed before and after performing the inspiratory exercise and consisted of recording the sustained vowel /a/, connected speech and maximum phonatory times (MPT) of vowels, fricative phonemes and counting numbers. In the auditory-perceptual judgment, the Vocal Deviation Scale (VSD) was used to verify the general degree of vocal deviation. Acoustic evaluation was performed using the PRAAT software and the parameters fundamental frequency (f0), jitter, shimmer, harmonium-to-noise ratio (HNR), Cepstral Peak Prominence Smoothed (CPPS), Acoustic Voice Quality Index (AVQI) and Acoustic Breathiness Index (ABI). To measure the aerodynamic measurements, the time of each emission was extracted in the Audacity program. Data were statistically analyzed using the Statistica for Windows software and normality was tested using the Shapiro-Wilk test. To compare the results, Student's and Wilcoxon's t tests were applied, adopting a significance level of 5%. Results There were no significant differences between the results of the JPA and the acoustic measures, in the pre and post inspiratory exercise moments. As for the aerodynamic measures, it was possible to observe a significant increase in the value of the TMF /s/ (p=0.008). Conclusion There was no change in vocal quality after the inspiratory exercise with stimulator and respiratory exerciser, but an increase in the MPT of the phoneme /s/ was observed after the exercise.

Cepstral Peak Prominence Smoothed - CPPS e Acoustic Voice Quality Index - AVQI em vozes infantis saudáveis e alteradas: comparação, relação com julgamento perceptivo-auditivo e pontos de corte / Cepstral Peak Prominence Smoothed - CPPS and Acoustic Voice Quality Index - AVQI in healthy and altered children's voices: comparation, relationship with auditory-perceptual judgment and cut-off points

RESUMO Objetivo Comparar as medidas acústicas de Cepstral Peak Prominence Smoothed (CPPS) e Acoustic Voice Quality Index (AVQI) de crianças com vozes normais e alteradas, relacionar com o julgamento perceptivo-auditivo (JPA) da voz e estabelecer pontos de corte. Método Gravações vocais das tarefas de vogal sustentada e contagem de números de 185 crianças foram selecionadas em um banco de dados e submetidas a análise acústica com extração das medidas de CPPS e AVQI, e ao JPA. O JPA foi realizado individualmente para cada tarefa e as amostras foram classificadas posteriormente como normal ou alterada, e para as tarefas em conjunto definindo-se se a criança passaria ou falharia em uma situação de triagem vocal. Resultados Crianças com JPA alterado e que falharam na triagem apresentaram valores menores de CPPS e maiores de AVQI, do que as com JPA normal e que passaram na triagem. O JPA da tarefa de vogal sustentada se relacionou ao CPPS e AVQI, e da tarefa de contagem de números relacionou-se apenas ao AVQI e CPPS números. Os pontos de corte que diferenciam crianças com e sem desvio vocal são 14,07 para o CPPS vogal, 7,62 para o CPPS números e 2,01 para o AVQI. Conclusão Crianças com JPA alterado apresentaram maiores valores de AVQI e menores valores de CPPs. O JPA da tarefa de vogal previu todas as medidas acústicas, porém, de contagem previu apenas as medidas extraídas dela. As três medidas foram semelhantes na identificação de vozes sem desvio e vozes disfônicas.

ABSTRACT Purpose To compare the acoustic measurements of Cepstral Peak Prominence Smoothed (CPPS) and Acoustic Voice Quality Index (AVQI) of children with normal and altered voices, to relationship with auditory-perceptual judgment (APJ) and to establish cut-off points. Methods Vocal recordings of the sustained vowel and number counting tasks of 185 children were selected from a database and submitted to acoustic analysis with extraction of CPPS and AVQI measurements, and to APJ. The APJ was performed individually for each task, classified as normal or altered, and for the tasks together defining whether the child would pass or fail in a situation of vocal screening. Results Children with altered APJ and who failed the screening had lower CPPS values and higher AVQI values, than those with normal APJ and who passed the screening. The APJ of the sustained vowel task was related to CPPS and AVQI, and APJ of the number counting task was related only to AVQI and CPPS numbers. The cut-off points that differentiate children with and without vocal deviation are 14.07 for the vowel CPPS, 7.62 for the CPPS numbers and 2.01 for the AVQI. Conclusion Children with altered voices, have higher AVQI values and lower CPPS values, when detected in children with voices within the normal range. The acoustic measurements were related to the auditory perceptual judgment of vocal quality in the sustained vowel task, however, the number counting task was related only to the AVQI and CPPS. The cut-off points that differentiate children with and without vocal deviation are 14.07 for the CPPS vowel, 7.62 for the CPPS numbers and 2.01 for the AVQI. The three measures were similar in identifying voices without deviation and dysphonic voices.

Future teachers and the self-perception of vocal symptoms and knowledge about vocal health and hygiene. / Futuros professores e a autopercepção de sintomas vocais e conhecimento em saúde e higiene vocal.

PURPOSE: To analyze responses of future teachers regarding the self-perception of vocal symptoms and knowledge about vocal health and vocal hygiene, relating them to sociodemographic and occupational variables and previous knowledge about voice. METHODS: Observational, analytical and cross-sectional study. A total of 264 undergraduate students participated and the Vocal Health and Hygiene Questionnaire (QSHV), Vocal Symptoms Scale (ESV) and a questionnaire with sociodemographic, occupational and vocal questions were applied. Data were statistically analyzed considering a 5% significance level. RESULTS: QSHV of future teachers had a total mean score of 21.89, suggestive of lack of knowledge about vocal health and hygiene. The results of the ESV are above the instrument's cutoff score, in each of the three domains and in the total score, there was greater symptomatology in first-year students when compared to other students, in the emotional, limitation and total domains. There was a difference when comparing the QSHV with the year of graduation (p=0.001), in which third and fourth year students obtained higher scores. A positive correlation was observed between the total QSHV score and the age variable (p=0.019). CONCLUSION: Future teachers present important vocal symptomatology, compatible with dysphonic individuals, and have insufficient knowledge about vocal health and hygiene. Knowledge is even lower among students in the early undergraduate years and at a younger age. Older future teachers demonstrate more knowledge about vocal health and hygiene. It is necessary to propose preventive actions with this population, even during the graduation period, aiming to reduce the risks of developing vocal problems in the medium or long term during teaching.

OBJETIVO: Analisar respostas de futuros professores quanto à autopercepção de sintomas vocais e conhecimento sobre saúde vocal e higiene vocal, relacionando-os às variáveis sociodemográficas, ocupacionais e conhecimento prévio sobre voz. MÉTODO: Estudo observacional, analítico e transversal. Participaram 264 alunos de licenciatura, foram aplicados Questionário de Saúde e Higiene Vocal (QSHV), Escala de Sintomas Vocais (ESV) e questionário com perguntas sociodemográficas, ocupacionais e vocais. Os dados foram analisados estatisticamente considerando nível de significância 5%. RESULTADOS: QSHV de futuros professores apresentou escore médio total de 21,89, sugestivo de conhecimento insuficiente sobre saúde e higiene vocal. Resultados da ESV estão acima da nota de corte do instrumento, nos três domínios e no escore total, observou-se maior sintomatologia em estudantes do primeiro ano quando comparados aos demais estudantes, nos domínios emocional, limitação e total. Houve diferença na comparação do QSHV com o ano da graduação (p=0,001), em que alunos dos terceiros e quartos anos obtiveram pontuações maiores. Observou-se correlação positiva entre escore total do QSHV e variável idade (p=0,019). CONCLUSÃO: Futuros professores apresentam sintomatologia vocal importante, compatível aos indivíduos disfônicos, e possuem conhecimento insuficiente sobre saúde e higiene vocal. O conhecimento é ainda menor em alunos dos anos de graduação iniciais e com menor idade. Futuros professores com mais idade demonstram ter mais conhecimento sobre saúde e higiene vocal. Faz-se necessária a proposição de ações preventivas à essa população, ainda no período da graduação, visando à diminuição dos riscos ao desenvolvimento de problemas vocais em médio ou longo prazo durante a docência.

Aspectos oromiofuncionais e fatores associados à autopercepção sobre a qualidade do sono em indivíduos com queixa de ronco / Oromyofunctional aspects and factors associated with self-perception of sleep quality in individuals with snoring complaints / Aspectos oromiofuncionales y factores asociados a la autopercepción de la calidad del sueño en individuos con quejas de ronquidos

Introdução: O sono é uma função vital e essencial para a sobrevivência humana e tem por objetivo favorecer o reparo corporal e mental. Objetivo: Investigar os fatores associados à autopercepção sobre a qualidade do sono, bem como possíveis alterações das estruturas orofaciais e funções estomatognáticas em indivíduos com queixa de ronco. Material e Método: Trata-se de estudo observacional, analítico e transversal, realizado com 30 indivíduos adultos com queixa de ronco durante o sono, com idade média de 45 anos e 5 meses. Para a avaliação de motricidade oromiofuncional foi utilizado o protocolo AMIOFE. Foram aplicados questionários para investigação do ronco e qualidade de sono dos participantes: Questionário de Berlin, Escala de Sonolência de Epworth e Questionário de qualidade de sono de Pittsburgh. Resultados: Os resultados do questionário de Pittsburgh indicaram disfunção na qualidade do sono em 66,67% dos participantes. A sonolência diurna foi evidenciada em 33,33%, por meio da Escala de Epworth. 60% dos participantes apresentaram alto risco para AOS, por meio dos escores obtidos no instrumento de Berlin. Indivíduos que não praticam exercício físico e com posição habitual de língua no assoalho bucal apresentaram maiores escores no questionário de Berlin. Houve correlação positiva estatisticamente significante e moderada entre as variáveis Índice de massa corporal (IMC) e os escores do Questionário de Berlin. Conclusão: Indivíduos com queixa de ronco apresentam dificuldades relacionadas à qualidade do sono. A autopercepção negativa de qualidade do sono teve relação com dados de motricidade orofacial, hábitos alimentares, composição corporal e hábitos de estilo de vida. (AU)

Introduction: Sleep is a vital and essential function for human survival and aims to promote bodily and mental repair. Objective: To investigate factors associated with self-perception of sleep quality, as well as possible alterations in orofacial structures and stomatognathic functions in individuals with snoring complaints. Material and Method: Observational, analytical and cross-sectional study, conducted with 30 adult individuals complaining of snoring during sleep, with a mean age of 45 years and 5 months. For the evaluation of orofacial myofunctional motricity, the (AMIOFE) was used. Questionnaires were applied to investigate the snoring and sleep quality of the participants: Berlin Questionnaire, Epworth Sleepiness Scale and Pittsburg Sleep Quality Index Questionnaire. Results: The Pittsburgh questionnaire results indicated sleep quality dysfunction in 66.67% of participants. Daytime sleepiness was evidenced in 33.33%, using the Epworth Scale. 60% of the participants presented high risk for obstructive sleep apnea syndrome (OSA), through the scores obtained in the Berlin questionnaire. Individuals who do not practice physical exercise and with usual tongue position on the oral floor presented higher scores in the Berlin questionnaire. There was a statistically significant and moderate positive correlation between the variables Body Mass Index (BMI) and the Berlin questionnaire scores. Conclusion: Individuals complaining of snoring self-reported difficulties related to sleep quality. The sleep quality difficulties self-reported were related to data on orofacial motricity, eating habits, body composition and lifestyle habits. (AU)

Introducción: El sueño es uma función vital y essencial para la supervivência human, tien como objetivo promover la reparación corporal y mental. Objetivo: Investigar los factores asociados con la autopercepción de la calidad del sueño, así como posibles alteraciones en las estructuras orofaciales y funciones estomatognáticas en individuos con quejas de ronquidos. Metodo: Se trata de estudio observacional, analítico, transversal, realizado con 30 individuos adultos con queja de ronquidos durante el sueño y edad media de 45 años y 5 meses. Para la evaluación de la motricidad oromiofuncional se utilizó el protocolo (AMIOFE/OMES). Se aplicaron cuestionarios para investigar el ronquido y la calidad de sueño de los participantes: Cuestionario de Berlín; Escala de Somnolencia de Epworth; Cuestionario de Calidad del Sueño de Pittsburgh. Resultados: Los resultados del cuestionario de Pittsburgh indicaron disfunción en la calidad del sueño en 66,67%. La Escala de Epworth evidenció somnolencia diurna en 33,33%. El 60% presentaron alto riesgo de AOS, conforme las puntuaciones obtenidas en el instrumento de Berlín. Los que no practican ejercicio físico y que tienen la posición habitual de la lengua en el piso de la boca obtuvieron puntuaciones más altas en el cuestionario de Berlín. Hubo correlación positiva estadísticamente significativa y moderada entre las variables del IMC y las puntuaciones del Cuestionario de Berlín. Conclusión: Individuos con quejas de ronquidos refieren dificultades relacionadas con la calidad del sueño. Las dificultades estuvieron relacionadas con datos de motricidad orofacial, hábitos alimentarios, composición corporal y los hábitos de estilo de vida. (AU)

Acoustic measurements of CPPS and AVQI pre and post speech therapy. / Medidas acústicas de CPPS e AVQI pré e pós terapia fonoaudiológica.

PURPOSE: To compare the acoustic measurements of Cepstral Peak Prominence-Smoothed (CPPS) and Acoustic Voice Quality Index (AVQI) at pre- and post-voice therapy times. METHODS: This is a before and after intervention study, with retrospective data collection. Twenty-two subjects with a mean age of 49.9 years participated in the study. The vocal therapy occurred between the years 2016 to 2019 in a teaching clinic, and the subjects had vocal samples collected before and after the therapeutic processes. CPPS and AVQI data extractions were performed during pre- and post-therapy. In order to characterize the sample, auditory-perceptual evaluation (APE) regarding the overall degree of vocal deviation at pre- and post-therapy moments was performed. The data were analyzed statistically. RESULTS: The APE data indicated a decrease in the median values of overall vocal deviation degree at the post-therapy stage for both the vowel (p=0.00) and number (p=0.00) samples. The average CPPS for the vowel was 14.53 pre-therapy and 16.37 post-therapy (p=0.01); for the number emission, it was 8.22 pre-therapy and 9.06 post-therapy (p=0.02), there was a difference in the CPPS of the vowel and numbers indicating vocal improvement at post-therapy. The average AVQI was 2.27 pre-therapy and 1.54 post-therapy (p=0.05). There was an improvement in the AVQI results, with borderline p-value. CONCLUSION: Vocal therapy produced changes in the general degree of vocal deviation, as well as in CPPS and AVQI measurements, and the results at the post-therapy moment are similar to those of vocally healthy individuals.

OBJETIVO: Comparar as medidas acústicas de Proeminência do Pico Cepstral Suavizado (CPPS) e Acoustic Voice Quality Index (AVQI) nos momentos pré e pós-terapia Vocal. MÉTODO: Trata-se de estudo de intervenção antes e após, com coleta de dados retrospectiva. Participaram do estudo 22 sujeitos com média de idade de 49,9 anos. A terapia vocal ocorreu entre os anos de 2016 a 2019 em uma clínica-escola, sendo que antes e após os processos terapêuticos, os sujeitos tiveram amostras vocais coletadas. Foram realizadas as extrações dos dados de CPPS e AVQI nos momentos pré e pós-terapia. A fim de caracterizar a amostra, foi realizado julgamento perceptivo-auditivo (JPA) referente ao grau geral do desvio vocal nos momentos pré e pós-terapia. Os dados foram analisados estatisticamente. RESULTADOS: Os dados do JPA indicaram diminuição nos valores medianos de grau geral do desvio vocal no momento pós-terapia, tanto para a amostra de vogal (p=0,00) quanto de números (p=0,00). A média do CPPS para a vogal foi de 14,53 pré-terapia e 16,37 pós-terapia (p= 0,01) e na emissão dos números foi de 8,22 pré-terapia e 9,06 pós-terapia (p=0,02), houve diferença no CPPS da vogal e dos números indicando melhora vocal pós-terapia. A média do AVQI foi de 2,27 pré-terapia e 1,54 pós-terapia (p= 0,05), houve melhora nos resultados do AVQI, com valor de p limítrofe. CONCLUSÃO: A terapia vocal produziu modificações no grau geral do desvio vocal e nas medidas de CPPS e AVQI, sendo que no momento pós terapia os resultados são semelhantes aos apresentados por indivíduos vocalmente saudáveis.

Futuros professores e a autopercepção de sintomas vocais e conhecimento em saúde e higiene vocal / Future teachers and the self-perception of vocal symptoms and knowledge about vocal health and hygiene

RESUMO Objetivo Analisar respostas de futuros professores quanto à autopercepção de sintomas vocais e conhecimento sobre saúde vocal e higiene vocal, relacionando-os às variáveis sociodemográficas, ocupacionais e conhecimento prévio sobre voz. Método Estudo observacional, analítico e transversal. Participaram 264 alunos de licenciatura, foram aplicados Questionário de Saúde e Higiene Vocal (QSHV), Escala de Sintomas Vocais (ESV) e questionário com perguntas sociodemográficas, ocupacionais e vocais. Os dados foram analisados estatisticamente considerando nível de significância 5%. Resultados QSHV de futuros professores apresentou escore médio total de 21,89, sugestivo de conhecimento insuficiente sobre saúde e higiene vocal. Resultados da ESV estão acima da nota de corte do instrumento, nos três domínios e no escore total, observou-se maior sintomatologia em estudantes do primeiro ano quando comparados aos demais estudantes, nos domínios emocional, limitação e total. Houve diferença na comparação do QSHV com o ano da graduação (p=0,001), em que alunos dos terceiros e quartos anos obtiveram pontuações maiores. Observou-se correlação positiva entre escore total do QSHV e variável idade (p=0,019). Conclusão Futuros professores apresentam sintomatologia vocal importante, compatível aos indivíduos disfônicos, e possuem conhecimento insuficiente sobre saúde e higiene vocal. O conhecimento é ainda menor em alunos dos anos de graduação iniciais e com menor idade. Futuros professores com mais idade demonstram ter mais conhecimento sobre saúde e higiene vocal. Faz-se necessária a proposição de ações preventivas à essa população, ainda no período da graduação, visando à diminuição dos riscos ao desenvolvimento de problemas vocais em médio ou longo prazo durante a docência.

ABSTRACT Purpose To analyze responses of future teachers regarding the self-perception of vocal symptoms and knowledge about vocal health and vocal hygiene, relating them to sociodemographic and occupational variables and previous knowledge about voice. Methods Observational, analytical and cross-sectional study. A total of 264 undergraduate students participated and the Vocal Health and Hygiene Questionnaire (QSHV), Vocal Symptoms Scale (ESV) and a questionnaire with sociodemographic, occupational and vocal questions were applied. Data were statistically analyzed considering a 5% significance level. Results QSHV of future teachers had a total mean score of 21.89, suggestive of lack of knowledge about vocal health and hygiene. The results of the ESV are above the instrument's cutoff score, in each of the three domains and in the total score, there was greater symptomatology in first-year students when compared to other students, in the emotional, limitation and total domains. There was a difference when comparing the QSHV with the year of graduation (p=0.001), in which third and fourth year students obtained higher scores. A positive correlation was observed between the total QSHV score and the age variable (p=0.019). Conclusion Future teachers present important vocal symptomatology, compatible with dysphonic individuals, and have insufficient knowledge about vocal health and hygiene. Knowledge is even lower among students in the early undergraduate years and at a younger age. Older future teachers demonstrate more knowledge about vocal health and hygiene. It is necessary to propose preventive actions with this population, even during the graduation period, aiming to reduce the risks of developing vocal problems in the medium or long term during teaching.

Medidas acústicas de CPPS e AVQI pré e pós terapia fonoaudiológica / Acoustic measurements of CPPS and AVQI pre and post speech therapy

RESUMO Objetivo Comparar as medidas acústicas de Proeminência do Pico Cepstral Suavizado (CPPS) e Acoustic Voice Quality Index (AVQI) nos momentos pré e pós-terapia Vocal. Método Trata-se de estudo de intervenção antes e após, com coleta de dados retrospectiva. Participaram do estudo 22 sujeitos com média de idade de 49,9 anos. A terapia vocal ocorreu entre os anos de 2016 a 2019 em uma clínica-escola, sendo que antes e após os processos terapêuticos, os sujeitos tiveram amostras vocais coletadas. Foram realizadas as extrações dos dados de CPPS e AVQI nos momentos pré e pós-terapia. A fim de caracterizar a amostra, foi realizado julgamento perceptivo-auditivo (JPA) referente ao grau geral do desvio vocal nos momentos pré e pós-terapia. Os dados foram analisados estatisticamente. Resultados Os dados do JPA indicaram diminuição nos valores medianos de grau geral do desvio vocal no momento pós-terapia, tanto para a amostra de vogal (p=0,00) quanto de números (p=0,00). A média do CPPS para a vogal foi de 14,53 pré-terapia e 16,37 pós-terapia (p= 0,01) e na emissão dos números foi de 8,22 pré-terapia e 9,06 pós-terapia (p=0,02), houve diferença no CPPS da vogal e dos números indicando melhora vocal pós-terapia. A média do AVQI foi de 2,27 pré-terapia e 1,54 pós-terapia (p= 0,05), houve melhora nos resultados do AVQI, com valor de p limítrofe. Conclusão A terapia vocal produziu modificações no grau geral do desvio vocal e nas medidas de CPPS e AVQI, sendo que no momento pós terapia os resultados são semelhantes aos apresentados por indivíduos vocalmente saudáveis.

ABSTRACT Purpose To compare the acoustic measurements of Cepstral Peak Prominence-Smoothed (CPPS) and Acoustic Voice Quality Index (AVQI) at pre- and post-voice therapy times. Methods This is a before and after intervention study, with retrospective data collection. Twenty-two subjects with a mean age of 49.9 years participated in the study. The vocal therapy occurred between the years 2016 to 2019 in a teaching clinic, and the subjects had vocal samples collected before and after the therapeutic processes. CPPS and AVQI data extractions were performed during pre- and post-therapy. In order to characterize the sample, auditory-perceptual evaluation (APE) regarding the overall degree of vocal deviation at pre- and post-therapy moments was performed. The data were analyzed statistically. Results The APE data indicated a decrease in the median values of overall vocal deviation degree at the post-therapy stage for both the vowel (p=0.00) and number (p=0.00) samples. The average CPPS for the vowel was 14.53 pre-therapy and 16.37 post-therapy (p=0.01); for the number emission, it was 8.22 pre-therapy and 9.06 post-therapy (p=0.02), there was a difference in the CPPS of the vowel and numbers indicating vocal improvement at post-therapy. The average AVQI was 2.27 pre-therapy and 1.54 post-therapy (p=0.05). There was an improvement in the AVQI results, with borderline p-value. Conclusion Vocal therapy produced changes in the general degree of vocal deviation, as well as in CPPS and AVQI measurements, and the results at the post-therapy moment are similar to those of vocally healthy individuals.

Vocal Characteristics of Children With Short Stature Before and After Growth Hormone Treatment.

OBJECTIVE: To evaluate the vocal characteristics of children with short stature before and 12 months after growth hormone treatment. MATERIAL AND METHODS: This analytical, observational cohort study included 23 children (age 5-11 years) diagnosed with short stature. Children in the short stature group (SSG) were matched (1:1) for age and sex with children with normal growth (normal stature group; NSG). Participants in the SSG underwent assessments before and 12 months after growth hormone treatment, while those in the NSG underwent the same assessments at baseline and 12 months. The assessments included evaluation of (A) vocal characteristics (history, vocal self-assessment, auditory-perceptual evaluation, and acoustic analysis), (B) anthropometry, (C) bone age, and (D) measurement of insulin-like growth factor-1 (IGF-1) levels. RESULTS: Children in the SSG had more vocal complaints (P = 0.026) than those in the NSG. The groups were similar in terms of vocal self-assessment and auditory-perceptual evaluation (P = nonsignificant). Results of acoustic analysis were also similar for fundamental frequency (F 0) and perturbation measures (P for both = nonsignificant). F 0 and speech frequency decreased significantly at 12 months in both groups. F1 values were higher at 12 months in the NSG, while F2 values were significantly higher in the baseline evaluation in boys in the SSG. Children in the SSG compared with those in the NSG presented a greater increase in height measurements at 12 months, although the anthropometric means were lower in both evaluations (P < 0.001). CONCLUSION: Vocal characteristics in children with short stature before and after treatment with growth hormone are comparable to those in children with normal growth.

Does Shyness Influence the Self-Perception of Vocal Symptoms, Public Speaking, and Daily Communication?

OBJECTIVES: The present study aimed to characterize and to verify the relationship between shyness and self-assessment of vocal symptoms, public speaking, and aspects of daily communication. METHODS: This is an observational, analytical, and cross-sectional study. Two hundred and sixty-four male and female participants, with a mean age of 21 years and without any vocal disorder. To measure the outcomes, the participants' scores were measured using the following self-assessment instruments: Revised Cheek and Buss Shyness Scale, Voice Symptom Scale, Self-Statements during Public Speaking Scale, and the Daily Communication Self-evaluation Questionnaire. A descriptive and inferential analysis of the data was performed. RESULTS: Shy persons had higher vocal symptomatology scores in the limitation, emotional, and total domain. Furthermore, they scored higher on the negative aspects of public speaking and lower on its positive aspects. In addition, they showed weaker loudness and higher pitch in daily communication, compared with nonshy persons. Statistically significant correlations were found between positive shyness scores and all domains of vocal symptoms, negative aspects of public speaking, and pitch in daily communication. However, negative correlation was found between the positive aspects of public speaking and loudness in daily communication. CONCLUSION: Shy persons have a higher self-evaluation with regard to the negative and less positive aspects of public speaking and most vocal symptoms, as well as weaker loudness and higher pitch in daily communication when compared to nonshy persons. The greater the perception of shyness, the greater the self-assessment with regard to daily communication and vocal symptoms and the negative aspects of public speaking.

Effect of Wearing a Face Mask on Vocal Self-Perception during a Pandemic.

OBJECTIVE: To analyze the vocal self-perception of individuals who wore face masks for essential activities and those who wore them for professional and essential activities during the coronavirus disease pandemic. MATERIALS AND METHODS: This was an observational, descriptive, cross-sectional study. The study included 468 individuals who were stratified into two groups: the Working Group, comprising individuals who wore face masks for professional and essential activities during the pandemic; and the Essential Activities Group, with individuals who wore face masks only for essential activities during the pandemic. The outcome measures tested were self-perception of vocal fatigue, vocal tract discomfort, vocal effort, speech intelligibility, auditory feedback, and coordination between speech and breathing. Descriptive and inferential statistics were performed. RESULTS: Face masks increased the perception of vocal effort, difficulty in speech intelligibility, auditory feedback, and difficulty in coordinating speech and breathing, irrespective of usage. Individuals who wore face masks for professional and essential activities had a greater perception of symptoms of vocal fatigue and discomfort, vocal effort, difficulties in speech intelligibility, and in coordinating speech and breathing. CONCLUSION: Use of face masks increases the perception of vocal symptoms and discomfort, especially in individuals who wore it for professional and essential activities.

Self-perception of insomnia, sleep quality, and musculoskeletal pain in dysphonic women: preliminary study.

OBJECTIVE: To evaluate the association between musculoskeletal pain, insomnia indices, and sleep quality with voice functioning among women. METHODS: Thirty women aged between 18 and 50 years old participated in two groups: dysphonic group (DG) - composed of 15 women diagnosed with behavioral dysphonia; and control group (CG) - composed of 15 vocally healthy women. All participants answered the Musculoskeletal Pain Investigation Questionnaire, Pittsburgh Sleep Quality Index (PSQI), and Insomnia Severity Index (ISI) questionnaires. Statistical tests were applied to compare groups and to relate outcome variables, with a significance of 5% (p<.05). RESULTS: Dysphonic women presented a higher frequency of musculoskeletal pain in the posterior neck, lower back, masseter, submandibular, and larynx regions. There was no statistically significant difference for the other compared variables. We observed that there was a difference in the comparison between pain in some head and neck regions and the quality of sleep and evidence of insomnia, both in DG and CG. CONCLUSIONS: Dysphonic women have a higher frequency of pain in the head and neck regions when compared to vocally healthy women. There is a difference between sleep quality, insomnia, and musculoskeletal pain, regardless of the presence of vocal and laryngeal alterations.

Impacto da pandemia da Covid-19 na autopercepção vocal e fatores preditivos em professores / Impact of the COVID-19 pandemic on vocal self-perception and predictive factors in teachers

RESUMO Objetivo Analisar a autopercepção de esforço vocal, sinais e sintomas vocais e fadiga vocal em professores antes e durante a pandemia da COVID-19; e os fatores relacionados a dados sociodemograficos e ocupacionais que pudessem prever a autopercepção durante a pandemia. Métodos Participaram do estudo 263 professores brasileiros que estavam trabalhando em home office durante a pandemia. Eles responderam um questionário sobre dados sociodemográficos e ocupacionais, escala de Borg CR10-BR adaptada para classificação de esforço vocal, Lista de Sinais e Sintomas Vocais e Índice de Fadiga Vocal. Os questionários de autoavaliação vocal foram respondidos duas vezes, considerando antes e durante a pandemia. Resultados A autopercepção de esforço vocal, sinais e sintomas vocais e fadiga vocal durante a pandemia em professores foi menor do que antes da pandemia. Na comparação dos desfechos por queixa vocal, os professores sem queixa vocal apresentaram valores menores do que aqueles com queixa vocal. Professores com queixas vocais durante a pandemia apresentaram maior autopercepção de fadiga vocal. Professores de educação infantil, ensino fundamental e ensino médio relataram mais sinais e sintomas vocais antes do que durante a pandemia. Conclusão Em geral, os professores relatam diminuição do esforço vocal e dos sinais e sintomas vocais durante a pandemia de COVID-19. Professores com queixas vocais apresentam maior percepção de esforço vocal, sinais e sintomas vocais e fadiga vocal. A presença de queixas vocais e as variáveis relacionadas à demanda vocal durante a pandemia estão relacionadas à percepção de esforço vocal, sinais e sintomas vocais e fadiga vocal.

ABSTRACT Purpose This study aims to analyze the self-perception of vocal effort, vocal signs and symptoms, and vocal fatigue in teachers before and during the COVID-19 pandemic; and factors related to sociodemographic and occupational data that could predict self-perception during the pandemic Methods Participants were 263 Brazilian teachers working from in-home office during the pandemic. They answered a questionnaire on sociodemographic and occupational data, adapted Borg CR10-BR for vocal effort ratings, Vocal Signs and Symptoms List, and Vocal Fatigue Index. The vocal self-assessment questionnaires were answered twice, considering the period before and during the pandemic. Results The self-perception of vocal effort, vocal signs and symptoms, and vocal fatigue during the pandemic in teachers was lower than before the pandemic. In comparing outcomes due to vocal complaints, teachers with no vocal complaints presented lower values than those with vocal complaints. Teachers with vocal complaints during the pandemic showed greater self-perception of vocal fatigue. Teachers at early education, elementary, and high schools self-reported more vocal signs and symptoms before than during the pandemic. Conclusion In general, teachers report decreased vocal effort and vocal signs and symptoms during the COVID-19 pandemic. Teachers with vocal complaints have a higher perception of vocal effort, vocal signs and symptoms, and vocal fatigue. The presence of vocal complaints and the variables related to vocal demand during the pandemic are related to the perception of vocal effort, vocal signs and symptoms, and vocal fatigue.

Vocal Signs and Symptoms Related to COVID-19 and Risk Factors for their Persistence.

OBJECTIVE: To compare the occurrence of vocal signs and symptoms before, during, and after coronavirus disease (COVID-19) and analyze possible risk factors for the persistence of these signs and symptoms after disease resolution. METHODS: This was an observational, analytical, and cross-sectional study. The participants were 45 individuals of both sexes, with a mean age of 44 years, who were previously affected by COVID-19. All participants answered a questionnaire about sociodemographic data, smoking history, disease course, vocal complaints, and the vocal signs and symptoms list (SSL), referring to three timepoints (before, during, and after COVID-19). RESULTS: The most commonly reported vocal signs and symptoms before COVID-19 were phlegm (26.67%; n=12) and dry throat (24.44%; n=11). During COVID-19, the most frequent vocal signs and symptoms were tired voice after short-term use (73.33%; n=33) and dry throat (71.11%; n=32). After the disease, the most reported vocal signs and symptoms were dry throat (57.78%; n=26) and phlegm (53.33; n=24). The self-perception of vocal signs and symptoms before COVID-19 was lower than that during and after COVID-19 (P < 0.001). Vocal complaints after COVID-19 and oxygen therapy were predictors of self-perception of vocal signs and symptoms after COVID-19. CONCLUSIONS: Individuals affected by COVID-19 had a higher frequency of vocal signs and symptoms during the disease. However, after remission, the frequency of vocal signs and symptoms was higher than that at baseline. The need for oxygen therapy may indicate a risk for a higher occurrence of vocal signs and symptoms after COVID-19.

Vocal Symptoms in Brazilian Professors: Self-Perception and Relationship Factors.

OBJECTIVE: This study aimed to investigate the self-perception of vocal symptoms and relationship factors in Brazilian academic teacher. METHODS: This was a cross-sectional study. The study sample consisted of 235 Brazilian academic teachers, of whom 103 were men and 132 women, aged between 26 and 67 years, and employed at 39 institutions. All participants filled out a questionnaire detailing the presence of vocal complaints, and occupation and sociodemographic information. The vocal symptoms were investigated using voice symptom scale. RESULTS: Academic teacher with vocal complaints showed a higher perception of vocal symptoms in all domains (P < 0.001 for all). Other factors did not result in any significant difference. CONCLUSION: The only factor that influences the self-perception of vocal symptoms in Brazilian academic teachers is the presence of vocal complaints.

Comparison of the immediate effect of voiced oral high-frequency oscillation and flow phonation with resonance tube in vocally-healthy elderly women. / Comparação do impacto imediato das técnicas de oscilação oral de alta frequência sonorizada e sopro sonorizado com tubo de ressonância em idosas vocalmente saudáveis.

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.

OBJETIVO: Verificar e comparar os efeitos imediatos da técnica de oscilação oral de alta frequência sonorizada (OOAFS) e sopro sonorizado com tubo de ressonância na autopercepção de sintomas vocais/laríngeos e na qualidade vocal de idosas. MÉTODO: Participaram 14 mulheres idosas que realizaram as técnicas OOAFS e sopro sonorizado com tubo de ressonância de silicone, com wash-out de uma semana. Todas responderam questões sobre frequência e intensidade dos sintomas vocais/laríngeos; foram submetidas à gravação da vogal sustentada /a/ e contagem de números, para análise perceptivo-auditiva e acústica vocal. Foram extraídos os tempos máximos de fonação (TMF). Em seguida, sorteou-se a técnica a ser realizada: OOAFS ou tubo de ressonância, por três minutos em tom habitual. Após exercício, os mesmos procedimentos da avaliação inicial foram repetidos e as idosas responderam a um questionário de autoavaliação sobre os efeitos das técnicas. Os dados foram comparados antes e após aplicação das técnicas por meio dos testes ANOVA, Wilcoxon e Mann-Whitney; para as sensações vocais após técnicas, aplicou-se teste Quiquadrado(p<0,05). RESULTADOS: Ao comparar as técnicas, verificou-se diminuição da rugosidade e melhora da ressonância na contagem dos números após tubo de ressonância e manutenção dos resultados após OOAFS. Não houve mais diferenças significantes para as demais variáveis estudadas entre os grupos. CONCLUSÃO: O sopro sonorizado com tubo de ressonância melhora a qualidade vocal de mulheres idosas. Além disso, ambos os exercícios apresentaram semelhanças na autopercepção dos sintomas vocais/laríngeos e sensações, sugerindo que a OOAFS é segura e pode ser empregada na terapia de voz nesta população.

Immediate Effect of Semioccluded Vocal Tract Exercises Using Resonance Tube Phonation in Water on Women Without Vocal Complaints.

OBJECTIVE: To analyze the immediate effects of semioccluded vocal tract exercises on vocal quality and vocal self-assessment using resonance tube phonation in water in women without voice complaints, and to compare these results with those obtained using tongue trills and unvoiced fricative exercises. METHODS: This was a quasi-experimental study. The participants were 30 women aged 18-39 years and without vocal complaints. All participants performed three exercises for 3 minutes: experimental exercise (EE: phonation into a resonance flexible tube in water exercise), control exercise (tongue trill exercise), and placebo exercise (PE: unvoiced fricative exercise). Three outcomes were analyzed-vocal self-assessment, auditory-perceptual evaluation, and acoustic analysis. RESULTS: The vocal self-assessment showed significantly greater improvement after EE than after the other exercises. There were no significant differences in auditory-perceptual evaluation or acoustic analyses in any of the voice exercises. CONCLUSION: The EE promoted an immediate positive effect in the subjective self-assessment, with better results compared with PE. However, the clinical vocal evaluation did not indicate immediate positive effects after 3 minutes of EE, control exercise, or PE.

Comparação do impacto imediato das técnicas de oscilação oral de alta frequência sonorizada e sopro sonorizado com tubo de ressonância em idosas vocalmente saudáveis / Comparison of the immediate effect of voiced oral high-frequency oscillation and flow phonation with resonance tube in vocally-healthy elderly women

RESUMO Objetivo Verificar e comparar os efeitos imediatos da técnica de oscilação oral de alta frequência sonorizada (OOAFS) e sopro sonorizado com tubo de ressonância na autopercepção de sintomas vocais/laríngeos e na qualidade vocal de idosas. Método Participaram 14 mulheres idosas que realizaram as técnicas OOAFS e sopro sonorizado com tubo de ressonância de silicone, com wash-out de uma semana. Todas responderam questões sobre frequência e intensidade dos sintomas vocais/laríngeos; foram submetidas à gravação da vogal sustentada /a/ e contagem de números, para análise perceptivo-auditiva e acústica vocal. Foram extraídos os tempos máximos de fonação (TMF). Em seguida, sorteou-se a técnica a ser realizada: OOAFS ou tubo de ressonância, por três minutos em tom habitual. Após exercício, os mesmos procedimentos da avaliação inicial foram repetidos e as idosas responderam a um questionário de autoavaliação sobre os efeitos das técnicas. Os dados foram comparados antes e após aplicação das técnicas por meio dos testes ANOVA, Wilcoxon e Mann-Whitney; para as sensações vocais após técnicas, aplicou-se teste Quiquadrado(p<0,05). Resultados Ao comparar as técnicas, verificou-se diminuição da rugosidade e melhora da ressonância na contagem dos números após tubo de ressonância e manutenção dos resultados após OOAFS. Não houve mais diferenças significantes para as demais variáveis estudadas entre os grupos. Conclusão O sopro sonorizado com tubo de ressonância melhora a qualidade vocal de mulheres idosas. Além disso, ambos os exercícios apresentaram semelhanças na autopercepção dos sintomas vocais/laríngeos e sensações, sugerindo que a OOAFS é segura e pode ser empregada na terapia de voz nesta população.

ABSTRACT 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.

Características do sono de crianças respiradoras orais encaminhadas para realização de adenoidectomia e/ou amigdalectomia / Sleep characteristics in oral breathers pre adenoidectomy and/or tonsillectomy / Características del sueño de los niños respiradores orales encaminados para la realización de adenoidectomía y/o amigdalectomía

Introdução: A respiração oral acarreta diversas modificações na vida das crianças sendo uma delas as alterações na qualidade do sono, podendo ter impacto no desenvolvimento infantil. Objetivo: Compreender as características do sono de crianças com diagnóstico de respiração oral encaminhadas para a realização de cirurgias de adenoidectomia e/ou amigdalectomia prescritas pelo médico otorrinolaringologista, a partir das informações da família e das próprias crianças. Método: Estudo observacional, analítico, transversal e quantitativo, realizado com 100 crianças de ambos os sexos, com faixa etária entre cinco e 12 anos, divididas em dois grupos, sendo 50 crianças com respiração oral (GP) e 50 crianças sem diagnóstico de alteração respiratória (GC). A avaliação foi baseada no protocolo MBGR, classificação de Mallampati. Após a coleta, os dados foram tabulados e analisados estatisticamente a partir das variáveis queixa, qualidade e características do sono e classificação de Mallampati. Resultados: Os pais e/ou responsáveis não referiram espontaneamente informações relacionadas ao sono. Quando indagados sobre a qualidade do sono houve predomínio de sintomas para o GP. As principais queixas relacionadas ao sono foram ronco, sialorreia, agitação, boca seca, boca aberta, sono fragmentado, com maior ocorrência para o GP. Quanto à classificação de Mallampati houve predomínio dos graus II e III para o GP e grau I para o GC. Conclusão: Crianças respiradoras orais apresentam maior número de queixas referidas por pais/responsáveis em relação à qualidade do sono quando comparadas às crianças respiradoras nasais.

Introduction: Oral breathing entails several changes in the life of children, one of them being changes in sleep quality, which may have an impact on child development. Objective: To understand the sleep characteristics of children diagnosed with oral breathing referred for adenoidectomy and/or tonsillectomy surgeries prescribed by the otorhinolaryngologist, based on information from the family and the children themselves. Method: An observational, analytical, cross-sectional and quantitative study was carried out on 100 children of both sexes, with age range 5 and 12 years, divided into two groups: 50 children with oral breathing (EG) and 50 children without respiratory disorder (CG). The evaluation was based on the MBGR protocol, Mallampati score. After collection, the data were tabulated and analyzed statistically from the variables complaint, sleep quality and characteristics and Mallampati classification. Results: Parents and/or caregivers did not spontaneously report sleep-related information. When asked about sleep quality there was a predominance of symptoms for the EG. The main complaints related to sleep were snoring, sialorrhea, agitation, dry mouth, open mouth, fragmented sleep, with higher occurrence for the EG. Regarding the classification of Mallampati, there was a predominance of classes II and III for the EG and class I for the CG. Conclusion: Oral breathing children have a higher number of complaints reported by parents / guardians regarding sleep quality compared to nasal breathing children.

Introducción: La respiración oral acarrea diversas modificaciones en la vida de los niños siendo una de ellas las alteraciones en la calidad del sueño pudiendo tener impacto en el desarrollo infantil. Objetivo: Comprender las características del sueño de niños con diagnóstico d respiración oral encaminadas para la realización de cirugías de adenoidectomía y/o amigdalectomía prescritas por el médico otorrinolaringólogo, a partir de las informaciones de la familia y de los propios niños. Método: estudio observacional, analítico, transversal y cuantitativo, realizado con 100 niños de ambos sexos, con rango de edad entre cinco y 12 años, divididos en dos grupos, siendo 50 niños con respiración oral (GE) y 50 niños sin diagnóstico de cambio respiratorio (GC). La evaluación se basó em el protocolo MBGR, la clasificación de Mallampati. Después de la recolección, los datos fueron tabulados y analizados estadísticamente de las variables queja, calidad y características del sueño y clasificación de Mallampati. Resultados: Los padres y/o tutores no mencionaron espontáneamente información relacionada con el sueño. Cuando se indagó sobre la calidad del sueño hubo predominio de síntomas para el GE. Las principales quejas relacionadas con el sueño fueron ronquidos, sialorrea, agitación, boca seca, boca abierta, sueño fragmentado, con mayor ocurrencia para el GE. En cuanto a la clasificación de Mallampati hubo predominio de las clases II y III para el GE y clase I para el GC. Conclusión: Los niños con respiración oral tienen un mayor número de quejas reportadas por los padres / tutores con respecto a la calidad del sueño en comparación con los niños con respiración nasal.