Electrophysiological and Behavioral Evaluation of Auditory Processing in Adults with Dysphonia.

Introduction Dysphonia is an oral communication disorder. The voice and hearing are interrelated aspects. Hearing is an important sensory input for monitoring the vocal pattern. The relation between hearing abilities and dysphonia represents a contribution both in scientific and in clinical terms, especially in cases in which satisfactory results are not achieved in the therapeutic process. Objective To characterize long-latency auditory evoked potential (P300) with tonal and complex stimuli, and to make a behavioral evaluation of auditory processing in adults with behavioral dysphonia. Method The sample used for the present study consisted of 20 subjects from both genders with ages ranging from 18 and 58, who were diagnosed with behavioral dysphonia. The evaluations occurred in a single 2-hour session, in which the procedures of clinical history, pure tone and speech audiometries, acoustic immittance measures, and behavioral and electrophysiological evaluations of auditory processing were performed. Results The descriptive measures of P3 latency elicited by tonal and complex stimuli showed similar results for the right and left ears, without statistically significant differences. In the qualitative analysis, the results observed were within the normality patterns for the P3 component for both tonal and complex stimuli. As for the behavioral evaluation of auditory processing, abnormal results were observed in 100% of the sample. Abnormalities were found in the auditory skills of ordering and temporal resolution and figure-background obtained from the duration pattern, random gap detection, and dichotic tests (syllables and words), respectively. Conclusion The evaluated patients presented central auditory processing disorder, evidenced by behavioral assessment.

Dosage dependent effect of high-resistance straw exercise in dysphonic and non-dysphonic women. / Efeito do tempo de realização do exercício de canudo de alta resistência em mulheres disfônicas e não disfônicas.

PURPOSE: to study the dosage dependent effect of high-resistance straw exercise in women with behavioral dysphonia and in vocally healthy women. METHODS: 25 dysphonic women (DG), with average age of 35 years (SD = 10.5) and 30 vocally healthy women (VHG), with average age of 31.6 years (SD = 10.3). The participants produced a continuous sound into a thin high-resistance straw for seven minutes, being interrupted after the first, third, fifth and seventh minute. At each interval, speech samples were recorded (sustained vowel and counting up to 20) and subsequently acoustically analyzed. Each participant reported the effort necessary to perform exercise and to speak, indicating their ratings on visual analog scales (VAS). RESULTS: with regard to the DG, the exercise caused positive vocal changes, especially between the third and fifth minute: less phonatory effort, increase in MPT, and reduction of F0 variability; these voice parameters deteriorated after five minutes. This fact associated with the increased effort to perform the exercise indicates a possible overload of the phonatory system. As to the VHG, MPT improved after one minute of exercise, while the other parameters did not change over time, probably due to the fact that the voices were not deviant; seven minutes did not seem to impose an overload in this population. CONCLUSION: positive vocal changes were observed with the high-resistance straw exercise; however, there are dosage restrictions, especially for dysphonic women.

Efeito do tempo de realização do exercício de canudo de alta resistência em mulheres disfônicas e não disfônicas / Dosage dependent effect of high-resistance straw exercise in dysphonic and non-dysphonic women

RESUMO Objetivo Verificar o efeito do tempo de realização do exercício de canudo de alta resistência em mulheres com disfonia comportamental e em mulheres vocalmente saudáveis. Método As participantes, 25 mulheres disfônicas (GD), com idade média de 35 anos (DP = 10,5) e 30 mulheres vocalmente saudáveis (GVS), com idade média de 31,6 anos (DP = 10,3), emitiram um som contínuo em um canudo de alta resistência por 7 minutos, com interrupções depois de 1, 3, 5 e 7 minutos. Amostras de vogal sustentada “é” e contagem de números foram registradas (FonoView-4.6, CTS) antes do início da realização do exercício e depois de cada uma das séries. Posteriormente, foram analisadas acusticamente. Cada participante foi orientada a prestar atenção no esforço fonatório aplicado durante o exercício, bem como na fala, registrando sua intensidade em uma escala analógico-visual (EAV). Resultados Para o GD, houve predomínio de respostas positivas após 3 minutos de exercício, com melhora do esforço para falar, aumento do TMF e redução da variabilidade de F0; com a continuidade do exercício, esses parâmetros pioraram, sugerindo sobrecarga no sistema, e o esforço fonatório percebido no exercício piorou gradativamente com o tempo. Para o GVS, o único parâmetro que se modificou foi o TMF, que melhorou após 1 minuto; 7 minutos não parece significar sobrecarga para essa população. Conclusão Foram observadas modificações vocais positivas com o exercício de canudo de alta resistência, mas há limites quanto a sua dosagem. Deve-se observar efeitos não desejados para evitar sobrecarga vocal desnecessária, principalmente em mulheres disfônicas.

ABSTRACT Purpose to study the dosage dependent effect of high-resistance straw exercise in women with behavioral dysphonia and in vocally healthy women. Methods 25 dysphonic women (DG), with average age of 35 years (SD = 10.5) and 30 vocally healthy women (VHG), with average age of 31.6 years (SD = 10.3). The participants produced a continuous sound into a thin high-resistance straw for seven minutes, being interrupted after the first, third, fifth and seventh minute. At each interval, speech samples were recorded (sustained vowel and counting up to 20) and subsequently acoustically analyzed. Each participant reported the effort necessary to perform exercise and to speak, indicating their ratings on visual analog scales (VAS). Results with regard to the DG, the exercise caused positive vocal changes, especially between the third and fifth minute: less phonatory effort, increase in MPT, and reduction of F0 variability; these voice parameters deteriorated after five minutes. This fact associated with the increased effort to perform the exercise indicates a possible overload of the phonatory system. As to the VHG, MPT improved after one minute of exercise, while the other parameters did not change over time, probably due to the fact that the voices were not deviant; seven minutes did not seem to impose an overload in this population. Conclusion positive vocal changes were observed with the high-resistance straw exercise; however, there are dosage restrictions, especially for dysphonic women.

Immediate effects of the Finnish resonance tube method on behavioral dysphonia.

OBJECTIVE: To investigate the immediate effects of the Finnish resonance tube method for teachers with behavioral dysphonia. METHODS: Twenty-five female teachers (m=39.9 years of age) with at least a 5-year history of dysphonia were included. Additional inclusion criteria were the diagnosis of chronic behavioral dysphonia with an indication for speech therapy and the absence of any prior speech therapy. Subjects produced three sets of 10 tokens of sustained phonation with a 1-minute rest interval between tokens into a 27-cm glass tube immersed in at least 2 cm of water. Voice samples were recorded before and after these sets. The effects of these exercises were evaluated by self-assessment, auditory perceptual analysis, and acoustic evaluation involving extraction of fundamental frequency and visual spectrographic analysis. RESULTS: Sixty-eight percent of the teachers reported increased phonatory comfort and 52% reported improved voice quality after performing the exercises. Perceptual analysis indicated improved voice quality in the samples of counting numbers, confirmed by decreased instability, subharmonics, noise in high frequencies, and the tendency for reduced low frequency noise on spectrographic evaluation. Additionally, mean fundamental frequency decreased. CONCLUSION: The Finnish resonance tube method increased phonatory comfort and vocal changes suggestive diminished hyperfunction.