Effect of Wendler glottoplasty on voice and quality of life of transgender women

Abstract Objective: To investigate the effect of Wendler glottoplasty on voice feminization, voice quality and voice-related quality of life. Methods: Prospective interventional cohort of transgender women submitted to Wendler glottoplasty. Acoustic analysis of the voice included assessment of fundamental frequency, maximum phonation time formant frequencies (F1 and F2), frequency range, jitter and shimmer. Voice quality was blindly assessed through GRBAS scale. Voice-related quality of life was measured using the Trans Woman Voice Questionnaire and the self-perceived femininity of the voice. Results: A total of 7 patients were included. The mean age was 35.4 years, and the mean postoperative follow-up time was 13.7 months. There was a mean increase of 47.9 ± 46.6 Hz (p = 0.023) in sustained/e/F0 and a mean increase of 24.6 ± 27.5 Hz (p = 0.029) in speaking F0 after glottoplasty. There was no statistical significance in the pre- and postoperative comparison of maximum phonation time, formant frequencies, frequency range, jitter, shimmer, and grade, roughness, breathiness, asthenia, and strain scale. Trans Woman Voice Questionnaire decreased following surgery from 98.3 ± 9.2 to 54.1 ± 25.0 (p = 0.007) and mean self-perceived femininity of the voice increased from 2.8 ± 1.8 to 7.7 ± 2.4 (p = 0.008). One patient (14%) presented a postoperative granuloma and there was 1 (14%) premature suture dehiscence. Conclusion: Glottoplasty is safe and effective for feminizing the voice of transgender women. There was an increase in fundamental frequency, without aggravating other acoustic parameters or voice quality. Voice-related quality of life improved after surgery.

Effects of the Voiced Tongue Trill Technique in Glissandos on the Voice Range Profile of Choir Members: A Preliminary Study.

The objective of this study was to verify the immediate effect of the voiced tongue trill technique in ascending and descending glissandos on the voice range profile of choir members. A total of 25 sopranos, mezzo-sopranos, contraltos, tenors, and baritones participated in the study. They were choir members, aged 20 to 45 years, with no voice symptoms, and able to perform the voiced tongue trill technique. Their voice range profile was analyzed before and after performing the ascending and descending technique for 2 and 5 minutes. The maximum fundamental frequency values in the study groups increased after performing the ascending and descending technique for 2 minutes (P = 0.001) and 5 minutes (P = 0.003). The range in Hz increased after 2 minutes (P = 0.010) and 5 minutes (P = 0.050) of the ascending technique and after 2 minutes (P = 0.001) of the descending technique, and the minimum fundamental frequency mean value suffered interference from the type of technique (ascending/descending). The immediate effects of VTTT in glissandos on the VRP of choir members' considering the two factors: condition and time, in ascending and descending glissandos for 2 and 5 minutes increased the maximum frequency and the range in Hz of choristers. Regarding volume levels results, no difference was found in intensity after applying the technique.

Minor Structural Alterations of the Vocal Fold Cover: Vocal Quality before and after Treatment.

Introduction Minor structural alterations of the vocal fold cover are important causes of dysphonia. The variability in the type of alteration and the grade of vocal deviation affects the definition of the conduit and the results of treatment. Objective To characterize the occurrence, the selected treatments adopted and vocal quality before and after treatment in patients with minor structural alterations of the vocal folds cover. Methods This was a cross-sectional study based on the records of patients treated by an interdisciplinary team at the laryngology outpatient clinic of a public university hospital from 2010 to 2018. Data collection consisted of access to a database of information on otorhinolaryngological diagnostic hypotheses, intervention and perceptual-auditory vocal assessments before and after the treatment. Data from 102 subjects were analyzed. Association tests were applied between the perceptual-auditory vocal results and the different alterations found and between these and the adopted treatments. The results of the degrees of vocal deviation before and after treatment were also compared. Results The degree of roughness was associated with the sulcus vocalis, and in this alteration the highest occurrence was mild degree of roughness. There was an improvement in the breathiness and general grade of vocal deviation after treatment. Conclusion Cysts were the most frequent structural alteration in the population studied. There was an association between the degree of general deviation and that of roughness in sulcus vocalis cases. The breathiness and the general grade of vocal deviation improved after treatment regardless of the type of treatment and alteration.

Vocal Fold Polyps: Literature Review

Abstract Introduction Vocal fold polyps are one of themost frequent benign laryngeal lesions, impacting the quality of life of those affected by them, primarily the vocal production. Despite being a well-established therapy in conjunction with surgery, speech therapy alone may also be effective in treating these lesions. As such, otolaryngologists and speech therapists need updated bibliographic knowledge on the issue. Objective To describe the literature findings on vocal fold polyps that discuss prevalence, etiology, histology, physiopathology, vocal characteristics or treatment. Data Synthesis The present study is a review article based on a bibliographic search using platforms, databases and search engines, with no restrictions on means of publication, methodological quality or language. All the articles on vocal fold polyps pertaining to the object of study published in the past 15 years were included. Among the characteristics investigated, the most discussed were prevalence of men, smoking as an etiological cofactor, the possibility of histological differentiation from vocal nodules, the relationship with cover minor structural alterations, and the indication and effectiveness of different treatment options. Conclusion Despite the discrepancies found in the present literature review on vocal fold polyps, there has been a notable scientific progress in the otolaryngologic techniques and in the effectiveness of speech therapy as initial treatment, with direct and indirect techniques, corroborating the need for scientific investigation of the issue.

Vocal Fold Polyps: Literature Review.

Introduction Vocal fold polyps are one of the most frequent benign laryngeal lesions, impacting the quality of life of those affected by them, primarily the vocal production. Despite being a well-established therapy in conjunction with surgery, speech therapy alone may also be effective in treating these lesions. As such, otolaryngologists and speech therapists need updated bibliographic knowledge on the issue. Objective To describe the literature findings on vocal fold polyps that discuss prevalence, etiology, histology, physiopathology, vocal characteristics or treatment. Data Synthesis The present study is a review article based on a bibliographic search using platforms, databases and search engines, with no restrictions on means of publication, methodological quality or language. All the articles on vocal fold polyps pertaining to the object of study published in the past 15 years were included. Among the characteristics investigated, the most discussed were prevalence of men, smoking as an etiological cofactor, the possibility of histological differentiation from vocal nodules, the relationship with cover minor structural alterations, and the indication and effectiveness of different treatment options. Conclusion Despite the discrepancies found in the present literature review on vocal fold polyps, there has been a notable scientific progress in the otolaryngologic techniques and in the effectiveness of speech therapy as initial treatment, with direct and indirect techniques, corroborating the need for scientific investigation of the issue.

Técnica de vibração sonorizada de lábios e língua: revisão de literatura / Voiced lip and tongue trill technique: literature review / Técnica de vibración sonora de los labios y la lengua: revisión de la literatura

A técnica de vibração sonorizada de lábios e língua tem ampla aplicabilidade clínica e utilização. Para se compreender melhor a sua aplicação na clínica vocal, o objetivo desta revisão de literatura foi identificar a técnica de vibração sonorizada de lábios e língua quanto à classificação, principais indicações, resultados clínicos e tempo de execução. Foi realizada pesquisa bibliográfica na plataforma PubMed, portal de periódicos CAPES e site de busca Google Acadêmico. Foram incluídos artigos originais, revisões de literatura, anais de congresso, dissertações e teses que abordaram a técnica de vibração sonorizada de lábios ou língua, publicados nos últimos 10 anos, em português ou inglês. Foram excluídos livros, resenhas e editoriais. Foram ainda excluídos os artigos cuja técnica foi apenas citada, sem abordagem sobre efeitos vocais ou laríngeos imediatos, formas de utilização ou resultados clínicos obtidos. Inicialmente, foram encontradas 42 publicações. Após as etapas de seleção por título e resumo, restaram 20 artigos originais, um artigo de revisão de literatura e cinco dissertações. As publicações analisadas demonstraram que a técnica de vibração sonorizada de lábios ou língua é classificada como exercício do trato vocal semiocluído, suaviza o contato entre as pregas vocais, equilibra as pressões sub e supra glótica, otimiza o movimento muco-ondulatório e aumenta a resistência vocal. Suas principais indicações são aquecimento vocal, uso ocupacional da voz, disfonias hipercinéticas e lesões de massa em pregas vocais.

The voiced lip and tongue trill technique, has broad clinical applicability and use. To better understand their application in vocal clinic, the aim of this literature review was to identify the voiced tongue and lip vibration technique on the classification, main indications, clinical results and technical performance duration. Literature search was conducted in PubMed platform, portal CAPES and Google Scholar search site. There were included original articles, literature reviews, congress proceedings, dissertations and thesis that ddressed the sonorous lips or tongue vibration technique, published in the last 10 years, in Portuguese or English. There were excluded books and editorials. Articles whose technique was only cited without approach on immediate vocal or laryngeal effects, forms of use or clinical results were also excluded. Initially, were found 42 publications. After the steps of selection by title and abstract, it remained 20 original articles, 1 literature review and 5 dissertations. The publications analyzed showed that the voiced tongue and lip vibration technique is classified as an exercise of semi-occluded vocal tract, which softens the contact between the vocal folds, balances the subglottal and supraglottal pressure, optimizes the mucus-wave motion and increases vocal resistance. Its main indications are for vocal warm up, occupational use of voice, hyperkinetic dysphonia and mass lesions in the vocal folds.

La técnica de vibración sonora de labios y lengua tiene amplia aplicabilidad clínica y utilización. Para comprender mejor su aplicación en la clínica vocal, el objetivo de esta revisión de la literatura fue identificar las publicaciones sobre la técnica de vibraciones sonoras de labios y lengua en lo que respeta a la clasificación, indicaciones principales, resultados clínicos y tiempo de ejecución técnica. Búsqueda de la literatura se llevó a cabo en la plataforma PubMed, portal de periódicos CAPES y sitio de búsqueda Google Académico. Se incluyeron artículos originales, revisiones de la literatura, actas de congreso, disertaciones y tesis que abordaron la técnica de vibración sonora de labios y lengua, publicados en los últimos 10 años, en portugués o inglés. Se excluyeron libros, revistas y editoriales. También se xcluyeron los artículos donde la técnica fue sólo citada, sin enfoque en los efectos vocales o laríngeos inmediatos, formas de uso o resultados clínicos. Inicialmente, fueron encontradas 42 publicaciones. Después de las etapas de selección por título y resumen, se mantuvieron 20 artículos originales, 1 artículo de revisión de la literatura e 5 disertaciones. Las publicaciones analizadas mostraron que la técnica de vibración sonora de labios o lengua se clasifica como ejercicio de tracto vocal semi-ocluido, suaviza el contacto entre las cuerdas vocales, equilibra la presión sub glótica y supra glótica, optimiza el movimiento mocoondulatorio y aumenta la resistencia vocal. Sus principales indicaciones son el calentamiento vocal, uso profesionales de la voz, disfonías hipercinéticas y lesiones de masas en las cuerdas vocales. Palabras clave: deglución; trastornos de la deglución; fenómenos biomecánicos; hueso hioides; laringe.

Efetividade da fonoterapia no tratamento do pólipo em pregas vocais / Effectiveness of speech therapy in the treatment of vocal fold polyps

RESUMO: O objetivo dessa revisão de literatura foi verificar a efetividade da fonoterapia no tratamento do pólipo em pregas vocais, a partir de levantamento bibliográfico. Foi realizada pesquisa bibliográfica na plataforma PublicMedline e nas bases de dados Scopus, Science Direct, Cumulative Index to Nursing and Allied Health Literature e Web of Science, seguindo etapas de seleção e análise crítica dos artigos. Foram incluídos artigos originais que utilizaram a fonoterapia como tratamento para o pólipo vocal, sem restrições de data de publicação ou língua. Foram excluídos artigos que abordassem exclusivamente outros tratamentos para pólipo vocal e os que utilizaram a fonoterapia somente após a cirurgia laríngea. Foram encontrados inicialmente 905 artigos. Após as etapas de seleção, restaram nove artigos na composição final da amostra. Foram então analisados na íntegra, cadastrados por meio de protocolo previamente elaborado que contemplou autor, ano, local, tipo de estudo, amostra, classificação do pólipo, tipo de intervenção e principais resultados. Os artigos analisados apresentaram fragilidade metodológica e ausência de padronização quanto aos protocolos e procedimentos fonoaudiológicos utilizados. Foram constituídos em sua maioria por série de casos retrospectiva. A amostra dos estudos variou em relação à quantidade de participantes, tipo de lesão e tipo de pólipo. A fonoterapia para o tratamento do pólipo em pregas vocais demonstrou efetividade entre 38% e 100% nos estudos analisados, com melhores resultados em lesões pequenas e recentes.

ABSTRACT: The aim of this study was to verify the effectiveness of speech therapy in the treatment of vocal fold polyps by reviewing existing literature. Literature search was conducted through PublicMedline platform and the Scopus, Science Direct, Cumulative Index to Nursing and Allied Health Literature and Web of Science databases, followed by critical pre-selection and deep analysis of the articles. There were included original articles in which the speech therapy was used as treatment for vocal polyp, no publication date or language restrictions. There were excluded studies addressing just other treatments for vocal polyp and also articles in which the speech therapy was used only after laryngeal surgery. A total of 905 articles were found. However, after the selection stages, only nine articles were chosen to be part of the sample. The selected articles were fully analyzed, registered through previously developed protocol. The articles analyzed in this study showed poor methodology and lack of standardization regarding the speech therapy protocols and procedures used. It was consisted mostly by retrospective case series. The sample of studies reviewed presented variation in the number of participants, the type of lesion and type of polyp. The predominant type of intervention in the studies was the direct and indirect speech therapy associated, which demonstrated effectiveness in the treatment of polyps on the vocal folds. Speech therapy for the treatment of vocal fold polyps demonstrated effectiveness between 30% and 100% of the analyzed studies, with better results in small and recent polyps.

Perfil dos pacientes atendidos no Setor de fonoaudiologia - área de voz do Hospital das Clínicas da Universidade Federal de Pernambuco / Attendances accomplished in the section of speech-language therapy - Voice area at the Hospital das Clínicas da Universidade Federal de Pernambuco the Hospital das Clínicas

O objetivo deste trabalho foi descrever o perfil dos atendimentos realizados no Setor de Fonoaudiologia, área de voz, do serviço de Otorrinolaringologia dos Hospital das Clínicas da Universidade Federal de Pernambuco, no período de julho de 2001 a dezembro de 2003, segundo características dos pacientes e das patologias. Trata-se de um estudo observacional, transversal, seccional. Para análise dos dados foi utilizado o programa SPSS, realizando estatística descritiva e analítica. Foram analisados 155 atendimentos. Os pacientes apresentaram idade média de 41 ± 3 anos, com predomínio do sexo feminino (82,6por cento). As ocupações mais encontradas foram de profissionais da voz (25por cento) e de donas de casa (24,3por cento). O diagnóstico da disfonia predominante foi o organofuncional (55,8por cento), seguido do funcional (39por cento). A lesão da prega vocal mais prevalente foi o nódulo (34,5por cento), seguido do cisto (14,2por cento). Dos pacientes que interromperam o tratamento,53.3por cento receberam alta fonoaudiológia e 33,3 por cento abandonaram o tratamento. O tempo médio de duração do tratamento foi de 8,8 ± 0,8 meses. Os pacientes do sexo masculino apresentaram menor impacto negativo da disfonia em sua qualidade de vida em relação às mulheres (p=0,37). Este estudo possibilitou o surgimento de novas estratégias de atendimento no setor para uma melhor assistência ao paciente