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1.
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
2.
J Voice ; 34(1): 156.e1-156.e4, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30172669

RESUMO

OBJECTIVE: Functional dysphonia refers to a voice disorder without organic laryngeal disease. In this article, the clinical features and therapeutic strategies of functional dysphonia in children were investigated. METHOD: Retrospective analysis of 595 cases of children with dysphonia 3-18 years of age, including 42 patients diagnosed with functional dysphonia. The patients were distributed by age into four groups:3-6, 7-10, 11-14, 15-18 years. The clinical features, laryngeal signs, voice characteristics, pediatric voice handicap index, and therapeutic effects were analyzed. RESULT: In this study, 7.1% of the patients were struck with functional dysphonia. 7 (16.7%) patients aged 7-10 years, 16 (38.1%) aged 11-14 years, and 19 (45.3%) patients aged 15-18 years, and there were 23 males and 19 females. Thirteen (31.0%) patients had no cause identified, while some were triggered by upper respiratory tract infection (16 cases, 38.1%), voice overuse (9 cases, 21.4%), or other factors (4 cases, 9.5%). Thirty-four (80.9%) patients had prominent hoarseness, with aphonia in 25 (73.5%) patients, and other 7 (16.7%) patients (15-18 years) showed vocal breaks or vocal effort (4 patients), and high pitch or pitch instability (3 patients). Some patients were accompanied by reduced mucosal waves, supraglottic compensations, and glottal insufficiency. Twelve patients received voice therapy, and their voice was improved after treatment. CONCLUSION: In our study, functional dysphonia characterized 7.1% of the patients with voice disorders in children. All patients were 7-18 years of age, particularly 11-18 years. The main triggers of the disorder were upper respiratory tract infection, unknown and voice overuse. Other than apparent hoarseness, some 15-18 years patients experienced vocal breaks, vocal effort, or abnormal pitch. Supraglottic compensations and glottal insufficiency were observed in more than half of the patients. Symptomatic voice therapy obtained significant effects.


Assuntos
Desenvolvimento do Adolescente , Desenvolvimento Infantil , Disfonia/fisiopatologia , Qualidade da Voz , Adolescente , Idade de Início , Pequim/epidemiologia , Criança , Disfonia/diagnóstico , Disfonia/epidemiologia , Disfonia/terapia , Feminino , Humanos , Masculino , Prevalência , Recuperação de Função Fisiológica , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Treinamento da Voz
3.
Int J Pediatr Otorhinolaryngol ; 129: 109776, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31759227

RESUMO

AIM: To evaluate dysphonia rate and impact of vocal training in vocally trained (VT) and vocally untrained (VUT) children using the Lithuanian version of Glottal Function Index (GFI-LT) questionnaire. METHODS: 262 children (age range from 6 to 16 years) were included into prospective study. There were 115 consecutive children from four Music Schools in the VT group and 147 healthy children from four Secondary Schools in the VUT group. Dysphonia was suspected when the GFI-LT score was >3.0 points. The rate of singing activity and vocal training type (KLASAK) were evaluated. The means GFI-LT and dysphonia rate were compared between VT and VUT groups. Correlations between the GFI-LT and the degree of KLASAK were evaluated to assess the impact of vocal training on dysphonia rate. RESULTS: 28 (10.6%) children from the VT and 15 (5.7%) from VUT group did not pass the screening (p < 0.05). The mean GFI-LT scores in VT (2.4 ±â€¯3.1) and VUT (1.1 ±â€¯3.1) groups revealed a statistically significant difference (p < 0.001). The rate of dysphonia in the VT group (5.2%) was significantly higher (χ2 = 25.6, p < 0.05) than in the VUT group (2.1%). Significant correlations were found both between the GFI-LT scores and duration of attendance of Music School (r = 0.39, p < 0.001) as well as between dysphonia rate and voice load (KLASAK) (r = 0.34, p < 0.001). CONCLUSIONS: Vocal training could predispose to pediatric dysphonia. The greatest attention should be paid to children who engage in the extensive singing activities. GFI is a valid and reliable test to screen possible voice disorder early.


Assuntos
Disfonia/diagnóstico , Disfonia/epidemiologia , Inquéritos e Questionários , Treinamento da Voz , Adolescente , Criança , Feminino , Humanos , Lituânia/epidemiologia , Masculino , Estudos Prospectivos , Fatores de Risco , Canto
4.
Vestn Otorinolaringol ; 85(6): 71-77, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33474922

RESUMO

Drug-induced dysphonia is a non-life-threatening adverse drug reaction, however, this complication can significantly worsen the quality of life of patients, especially those in voice-speaking professions. The aim of the work was to search for information about the prevalence, etiology, pathogenesis, and features of treatment and prevention of drug-induced dysphonia. In the case of some drugs, the true prevalence may be higher than described in the literature, due to the fact that dysphonia is in most cases mild, reversible and, in comparison with other undesirable drug reactions, rarely attracts the attention of both the patient and practitioners.


Assuntos
Disfonia , Preparações Farmacêuticas , Disfonia/induzido quimicamente , Disfonia/diagnóstico , Disfonia/epidemiologia , Rouquidão , Humanos , Qualidade de Vida , Qualidade da Voz
5.
G Chir ; 40(3): 174-181, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31484005

RESUMO

OBJECTIVES: The aim of this study is to identify statistically significant differences in the onset of postoperative complications in patients undergoing thyroid surgery for benign pathology, following the systematic introduction of intraoperative neuromonitoring (IONM) of the laryngeal nerves. MATERIALS AND METHODS: In this study we have retrospectively analysed data of 604 consecutive patients underwent to thyroidectomy in the Unit of General Surgery - University Hospital of Parma between January 2011 and December 2017. All patients were divided in two groups: the first group of patients was operated without the use of IONM (Group A) the second group was operated after the introduction of the systematic use of IONM (Group B). We have compared the incidence of adverse events in these two groups, analysing the impact of IONM on the onset of the most frequent complications after thyroid surgery. We have considered the impact of other variables in both groups, such as thyroiditis, hyperfunction and gland sinking in mediastinum. RESULTS: No statistically significant differences in the incidence between Group A (patients operated without the use of IONM) and Group B (patients operated with the use of IONM) were detected, though a decreasing trend after the introduction of IONM was observed. No statistically significant differences were reported even analysing the influence of other patient's variables such as thyroiditis, hyperfunction and glandular sinking in mediastinum. CONCLUSION: Even if the number of patients considered is not sufficient to value statistically significant differences, the decreasing trend of the incidence of postoperative complications after introduction of IONM encourage us. The surgeon expertise is still the most relevant variable influencing the decreasing of postoperative complications, underlining the importance of the centralization of this kind of surgery in the high volume centres.


Assuntos
Monitorização Neurofisiológica Intraoperatória/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Doenças da Glândula Tireoide/cirurgia , Tireoidectomia/efeitos adversos , Disfonia/epidemiologia , Feminino , Humanos , Hipocalcemia/epidemiologia , Incidência , Monitorização Neurofisiológica Intraoperatória/métodos , Masculino , Hemorragia Pós-Operatória/epidemiologia , Estudos Retrospectivos
6.
J Pediatr ; 213: 46-51, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31402143

RESUMO

OBJECTIVE: To evaluate the role of upper airway dysfunction, indicated by altered vocal quality (dysphonia), on the respiratory symptoms of children surviving very preterm birth. STUDY DESIGN: Children born <32 weeks of gestation participated in 2 separate assessments during midchildhood. The first visit assessed voice quality by a subjective evaluation using the Consensus Auditory-Perceptual Evaluation of Voice and a computerized analysis of the properties of the voice via the Acoustic Voice Quality Index. The second assessment recorded parentally reported respiratory symptoms and measures of lung function, including spirometry, lung volumes, oscillatory mechanics, and a cardiopulmonary exercise test. RESULTS: Preterm children (n = 35; median gestation 24.3 weeks) underwent paired voice and lung assessments at approximately 11 years of age. Preterm children with dysphonia (n = 25) reported significantly more respiratory symptoms than those with normal voices (n = 10) including wheeze (92% vs 40%; P = .001) and asthma diagnosed by a physician (60% vs 10%; P = .007). Lung function outcomes were generally not different between the dysphonic group and the group with normal voice (P > .05), except for the oscillatory mechanics measures, which were all at least 0.5 z score lower in the dysphonic group (Xrs8 mean difference = -0.91 z scores, P = .003; fres = 1.06 z scores, P = .019; AX = -0.87 z scores, P = .010; Rrs8 = 0.63 z scores, P = .068). CONCLUSIONS: The upper airway may play a role in the respiratory symptoms experienced by some very preterm children and should be considered by clinicians, especially when symptoms are in the presence of normal lung function and are refractory to treatment.


Assuntos
Displasia Broncopulmonar/complicações , Disfonia/epidemiologia , Transtornos Respiratórios/epidemiologia , Criança , Feminino , Humanos , Lactente Extremamente Prematuro , Recém-Nascido , Masculino , Fatores de Risco , Espirometria , Qualidade da Voz
7.
Amyloid ; 26(4): 216-224, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31364411

RESUMO

Background: Systemic amyloidosis with cardiac involvement (CA) is a severe disease caused by the aggregation of misfolded proteins infiltrating organs and tissues and leading to their dysfunction. No study has yet focused on potential pharyngo-laryngeal impairments associated to CA. Our objective was to define its prevalence and describe pharyngo-laryngeal involvement patterns in a population with CA (light chain: AL, wild-type transthyretin: ATTRwt, variant transthyretin: ATTRv). Methods: Consecutive patients with a confirmed diagnosis of CA were prospectively investigated for pharyngo-laryngeal involvement. This included questionnaires on symptoms of dysphonia/dysphagia and quality of life Voice Handicap Index (VHI). In cases of dysphonia, a nasofibroscopy was performed to evaluate potential laryngeal organic lesions of amyloid infiltration and induced laryngeal dysfunction (mobility, glottic air leak). In cases of dysphagia, Video Endoscopy Swallowing Study (VESS) was performed to evaluate the presence of hypopharyngeal pooling at rest and during swallowing and the time of swallowing 80 ml of water. Results: Ninety-five CA patients were enrolled, of whom 19 were ATTRv, 36 AL and 40 ATTRwt. Their mean age was 73.8 ± 9.2 years and the sex ratio was 2.6 in favor of men. Dysphagia was reported in 17% of the patients and 40% had more specific oropharyngeal symptoms (food sticking, regurgitation, change in dietary habits), preceding the CA diagnosis by 7 (0-24) months. Recent weight loss was reported in 60% of the patients (mean loss of 10 ± 6.3 kg). VESS showed functional swallowing impairment in only 4 patients without any macroscopic organic lesion. Dysphonia was reported in 36% of the patients (44% and 47% in AL and ATTRv sub-groups, respectively) of whom 40% had functional or organic laryngeal abnormality (14% of vocal fold mobility dysfunction and 26% of abnormal mucosa) without any macroscopic-specific lesions of amyloid infiltration in these patients. Conclusions: This prospective study suggests, for the first time, that amyloid associated with CA could infiltrate the various anatomical structures of the pharyngo-larynx, responsible for functional impairment and potential nutritional depletion and poor quality of life.


Assuntos
Neuropatias Amiloides Familiares/complicações , Transtornos de Deglutição/complicações , Disfonia/complicações , Cardiopatias/complicações , Amiloidose de Cadeia Leve de Imunoglobulina/complicações , Idoso , Neuropatias Amiloides Familiares/epidemiologia , Neuropatias Amiloides Familiares/genética , Transtornos de Deglutição/epidemiologia , Disfonia/epidemiologia , Feminino , Cardiopatias/epidemiologia , Cardiopatias/genética , Humanos , Amiloidose de Cadeia Leve de Imunoglobulina/epidemiologia , Amiloidose de Cadeia Leve de Imunoglobulina/genética , Masculino , Prevalência , Estudos Prospectivos
8.
Ann Ig ; 31(3): 230-235, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31069367

RESUMO

BACKGROUND: Acoustic pollution is generally analysed in relation to the risks for the hearing apparatus, omitting the extra-auditory effects, such as the damage that the noise can cause to the speaker's voice and listening to the learning of the vocal message. These damages are mainly found in school environments among teachers. OBJECTIVE: A cross-sectional study was carried out to verify the influence that the noise of the classrooms can have on the physical and mental health of the teachers examined. METHODS: This study involved four schools of Rome, for a total of 60 teachers, who were interviewed via online questionnaires, which consisted of a socio-demographic data section and 3 other sections: Vocal Handicap Index (VHI), SF-12, Job Content Questionnaire. RESULTS: 50 responses were received. 68% of teachers exceeded the normative value of 2.83 and perceived a disorder of the voice, and only 32% had a value lower than the standard considered (mean=7.34; median=5). The medians of MCS12 and PCS12 scores (52.9 and 54.2) were very close to those of the general population, as well as the distribution of the scores obtained from the Job Content Questionnaire. Furthermore, there was a direct association between the VHI-10 score and the age (B=0.321 p=0.016), the marital status (B=0.345 p= 0.009), and an indirect association with the MCS12 (B=-0.283 p=0.033). CONCLUSIONS: In general, the teachers examined are exposed in the classrooms to a high acoustic climate (median=75 dB) and, consequently, to a vocal effort during the didactic activities. Although it has not been possible to verify whether teachers with a high vocal disturbance were in the classrooms with a worse acoustic climate, the descriptive analyses provide a solid basis for further studies on the association between noise pollution and vocal effort.


Assuntos
Ruído Ocupacional/efeitos adversos , Ruído/efeitos adversos , Berçários para Lactentes , Doenças Profissionais/epidemiologia , Professores Escolares/estatística & dados numéricos , Instituições Acadêmicas , Distúrbios da Voz/epidemiologia , Adulto , Fatores Etários , Estudos Transversais , Autoavaliação Diagnóstica , Disfonia/epidemiologia , Disfonia/etiologia , Disfonia/psicologia , Humanos , Satisfação no Emprego , Casamento , Pessoa de Meia-Idade , Ruído Ocupacional/estatística & dados numéricos , Doenças Profissionais/psicologia , Qualidade de Vida , Fatores de Risco , Professores Escolares/psicologia , Distúrbios da Voz/etiologia , Distúrbios da Voz/psicologia
9.
J Clin Neurosci ; 64: 111-115, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30948311

RESUMO

Voice and swallowing impairments are common in movement disorders, but their effect on patients' quality of life is not well known. This study was conducted to determine the onset and prevalence of patient-reported dysphonia and dysphagia symptoms in Parkinson's disease (PD), dystonia, Atypical Parkinsonian Syndromes (APS), and Essential Tremor (ET). Patients referred to a movement disorders clinic in a tertiary care academic medical center completed validated voice and swallowing specific Quality of Life (QOL) questionnaires: Voice Handicap Index-10 (VHI-10) and Eating Assessment Tool-10 (EAT-10). Patient demographics and clinical data were also collected. Two hundred and sixty-eight patients (males = 150, females = 118) completed the questionnaires (n was PD = 103, APS = 30, ET = 56, dystonia = 32, other = 47). Prevalence of patient-reported dysphagia symptoms was significantly higher in APS (63%) than PD (26%), ET (25%), and dystonia (31%). Prevalence of patient-reported dysphonia symptoms was significantly lower in ET (14%) compared to PD (34%) and APS (43%). Disease duration was shorter in PD and APS compared to ET and dystonia (p < 0.05) before reporting clinically significant dysphonia and dysphagia symptoms indicating an earlier onset of these symptoms. There were significant positive correlations between VHI-10 and EAT-10 scores and disease severity, as indicated by Unified Parkinson's Disease motor scores (p < 0.0001) and modified Fahn-Tolosa-Marin Tremor Rating sub-scores (p = 0.0013). Patient-reported dysphonia and dysphagia symptoms were present in one fourth of patients with PD, ET, dystonia, and almost two thirds in APS. Patient-reported QOL measures, such as VHI-10 and EAT-10, can help screen movement disorder patients for dysphonia and dysphagia symptoms.


Assuntos
Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/etiologia , Disfonia/epidemiologia , Disfonia/etiologia , Transtornos dos Movimentos/complicações , Centros Médicos Acadêmicos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Inquéritos e Questionários
10.
Curr Opin Otolaryngol Head Neck Surg ; 27(3): 168-177, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30920986

RESUMO

PURPOSE OF REVIEW: Presbylaryngis is the term used to describe changes in the larynx with ageing. It represents an increasingly common complaint as global populations continue to grow and get older. Presbylaryngis has a significantly negative impact on patients' quality of life and their ability to participate in society. This article will review the relevant literature on the incidence, pathophysiology, clinical evaluation, and treatment modalities for presbylaryngis. RECENT FINDINGS: The recently developed Ageing Voice Index (AVI) constitutes the first validated instrument for voice complaints specifically for the elderly. The evidence suggests that the bedrock of treating presbylaryngis centres on voice therapy. Thus, voice therapy should represent the primary treatment offered with surgery reserved for those failing to adequately respond. However, the comparative effectiveness of the different surgical interventions, namely injection laryngoplasty and thyroplasty, remains undetermined highlighting the need for larger, prospective, comparative studies. SUMMARY: Presbylaryngis is characterized by specific changes at the microscopic level resulting in age-related vocal fold atrophy. However, its presence alone does not always result in symptomatic dysphonia and equally, presbyphonia is often multifactorial involving the lower respiratory tract in addition to the larynx. Thus, the role of a multidisciplinary voice clinic for presbylaryngis cannot be overstated.


Assuntos
Disfonia/fisiopatologia , Disfonia/terapia , Fatores Etários , Idoso , Disfonia/diagnóstico , Disfonia/epidemiologia , Humanos , Qualidade de Vida , Acústica da Fala , Estroboscopia , Qualidade da Voz , Treinamento da Voz
11.
Ann Otol Rhinol Laryngol ; 128(4): 316-322, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30614248

RESUMO

OBJECTIVES:: To determine the impact of socioeconomic status (SES) on voice outcomes for spasmodic dysphonia (SD) patients treated with botulinum toxin injections. METHODS:: This was a prospective cross-sectional study in a tertiary care, academic voice clinic in Canada. Adult SD patients returning to the voice clinic for their botulinum toxin injections were recruited from October 2017 to April 2018. Patients completed a questionnaire on demographic data, the Hollingshead Four-Factor Index for socioeconomic status (validated instrument based on education, occupation, gender, and marital status), and the Voice-Handicap Index 10 (VHI-10) (validated instrument on self-reported vocal handicap). Primary outcome was the association between VHI-10 and Hollingshead Index. Secondary variables were median household income by postal code, duration of disease, gender, age, and professional voice user. Descriptive statistics and multiple linear regression were conducted. RESULTS:: One hundred and one patients (age = 62.8 ± 13.7 years, 20.8% male) were recruited with VHI-10 of 22.1 ± 8.1 (out of 40) and Hollingshead Index of 46.3 ± 11.7 (range, 8-66). Median household income was $75 875 ± $16 393, which was above the Canadian average of $70 336. About 91.1% were Caucasian, 54.4% had university degree, 86.1% spoke English, and 43.5% were employed. In multiple linear regression, there was mild to moderate negative correlation (r = -.292, P = .004) between VHI-10 and Hollingshead Index when controlling for disease duration, age, gender, and professional voice use. CONCLUSION:: SD patients treated with botulinum toxin were mostly affluent, Caucasian, well educated, and English speakers. Lower self-perceived vocal handicap was associated with higher socioeconomic status.


Assuntos
Toxinas Botulínicas , Disfonia , Classe Social , Qualidade da Voz , Idoso , Atitude Frente a Saúde , Toxinas Botulínicas/administração & dosagem , Toxinas Botulínicas/efeitos adversos , Canadá/epidemiologia , Estudos Transversais , Avaliação da Deficiência , Disfonia/epidemiologia , Disfonia/fisiopatologia , Disfonia/psicologia , Disfonia/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neurotoxinas/administração & dosagem , Neurotoxinas/efeitos adversos , Estudos Prospectivos , Autorrelato/estatística & dados numéricos
12.
Otolaryngol Pol ; 74(2): 17-22, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32022701

RESUMO

INTRODUCTION: Coexistence of dysphagia with voice disorders is a topic rarely raised in the literature. Particular attention is paid to the aspect of dysfunction of laryngeal and pharyngeal muscles. AIM: The aim of the study was to analyse cases of patients with dysphonia in relation to coexistence of swallowing disorder. MATERIAL AND METHOD: The material of the study included 515 patients hospitalised due to dysphonia in 2018. Patients whose interview indicated swallowing difficulties were subjected to additional diagnosis for dysphagia (FEES, extended speech therapy test, SEMG). R esults: 11.8% of people requiring treatment for voice disorders reported coexistence of swallowing difficulties. Dysphagia was diagnosed in 9.3%. The percentage of respondents diagnosed with swallowing disorder differed depending on the type of underlying disease and was the highest in the group with neurological disorders. Analysis of the correlation between the severity of dysphagia (according to the assessed grade, DHI, EAT-10 results) and the severity of VHI showed a weak correlation between VHI and EAT-10 (p = 0.1), statistically significant correlations (p < 0,05) between the value of VHI and RSI in people with diagnosed neurological disease, between the value of VHI and DHI in people with hyperfunctional dysphonia and the value of VHI and BMI and EAT- 10 in people with chronic laryngitis. Moreover, statistically significant correlations were found between the severity of dysphagia and EAT-10 and DHI (p < 0.05). The speech therapy test indicated the co-existing problem of non-normative swallowing pattern. The electromyographic study showed the largest asymmetries in recording the average and maximum amplitude from masseters. C onclusions: Treatment of patients with voice disorders requires interdisciplinary care. A history of dysphagia in these patients should complement the medical history of voice disorders. The characteristics of swallowing disorders vary depending on the cause of the voice disorder and their co-occurrence affects on average 9.3% of patients. Coexistence of muscle tension dysphagia with voice disorder requires separate diagnostic protocol. Logopaedic procedure ought to be a key element in the interdisciplinary care of patients suffering from muscle tension dysphagia.


Assuntos
Transtornos de Deglutição/etiologia , Transtornos de Deglutição/fisiopatologia , Disfonia/complicações , Disfonia/fisiopatologia , Idoso , Comorbidade , Transtornos de Deglutição/epidemiologia , Avaliação da Deficiência , Disfonia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Índice de Gravidade de Doença , Inquéritos e Questionários
13.
J Voice ; 33(5): 708-711, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29884508

RESUMO

OBJECTIVES: To examine the prevalence of dysphagia in patients presenting with dysphonia and diagnosed with non-neoplastic vocal fold pathology. METHODS: A total of 45 patients presenting with dysphonia and diagnosed with non-neoplastic vocal fold pathology and a control group matched according to age and gender were included. Patients with recent history of respiratory tract infection, laryngeal surgery or manipulation, neurologic disorders, head and neck tumors, or history of chemotherapy/radiotherapy were excluded. The primary outcome measure for dysphagia was Eating Assessment Tool-10. Patients with a score above three were considered to have dysphagia. RESULTS: The 45 patients were stratified as 18 males and 27 females, with an overall mean age of 48.23 ± 14.65 years. The most common vocal fold pathology was Reinke edema (28.8%), followed by laryngitis (24.4%), and vocal fold nodules (17.7%) and polyps (13.33%). Out of 45 patients with dysphonia, 37.7% had dysphagia and out of 25 controls, 8% had dysphagia as evidenced by an Eating Assessment Tool-10 score of above three. This prevalence is higher than normative values reported in the literature (16%-22%). CONCLUSIONS: The high prevalence of dysphagia in patients with non-neoplastic vocal fold pathology alludes to the pathogenic role of laryngeal behavior in the development of obstructive swallowing symptoms. The potential benefit of voice and swallowing therapy in the treatment of these patients should be considered.


Assuntos
Transtornos de Deglutição/epidemiologia , Disfonia/epidemiologia , Prega Vocal/patologia , Adulto , Estudos de Casos e Controles , Deglutição , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/fisiopatologia , Disfonia/patologia , Disfonia/fisiopatologia , Feminino , Humanos , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Prega Vocal/fisiopatologia , Qualidade da Voz
14.
Int J Pediatr Otorhinolaryngol ; 118: 59-61, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30583194

RESUMO

OBJECTIVE: To report on the prevalence of voice disturbances in pediatric airway patients. METHODS: Consecutive patients seen in a specialized Center for Airway Disorders at a tertiary children's hospital from February 2017 to September 2017 were included. Patients' families were invited to complete a pediatric voice health handicap index (pVHI) questionnaire. Patients underwent evaluation including flexible laryngoscopy and/or direct laryngoscopy and bronchoscopy. RESULTS: 146 patients were included. Of these children, 73 patients (50.3%) presented with swallowing difficulty and 44 patients (30.3%) presented with respiratory complaints. Only 9 patients (6.2%) reported hoarseness initially. The median age at referral was 2.7 years of age (interquartile range: 1.4-4.3). The mean total pVHI score was 9.5 (± 12.9). Sixty-seven patients (45.9%) had abnormal pVHI findings of score > 4. Six patients (4.1%) had pVHI > 40. The mean pVHI score was 26.0 (± 21.1) among 12 patients with a history of tracheostomy, 12.0 (± 14.3) among 30 patients with laryngeal cleft, and 9.0 (± 9.9) among 19 patients with laryngomalacia. CONCLUSION: Voice disturbances are not uncommon in pediatric patients evaluated for airway disorders. Although patients may present with primary concerns for breathing or swallowing difficulties, many of these patients may need further work-up and treatment for dysphonia.


Assuntos
Transtornos de Deglutição/epidemiologia , Disfonia/epidemiologia , Rouquidão/epidemiologia , Broncoscopia , Pré-Escolar , Anormalidades Congênitas/epidemiologia , Feminino , Humanos , Lactente , Laringomalácia/epidemiologia , Laringoscopia , Laringe/anormalidades , Masculino , Prevalência , Sistema Respiratório , Índice de Gravidade de Doença , Inquéritos e Questionários , Traqueostomia/estatística & dados numéricos
15.
Clin Rheumatol ; 38(1): 77-84, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29728930

RESUMO

This cross-sectional investigation examined the prevalence and severity of dysphonia, globus pharyngeus, and dysphagia in patients affected by immunomediated (IM) diseases. Seventy subjects were administered the Voice Handicap Index (VHI) (scale 0-4), Glasgow-Edinburgh Throat Scale (GETS) (scale from 0 to 7) for globus pharyngeus assessment, and modified Swallowing Outcomes After Revised Laryngectomy (SOAL) (scale 0, 1, 2) to test swallowing symptoms. VHI: the mean percentage of answers with a score greater than 1 (corresponding to a frequency of situation's occurrence "sometimes," "almost always," or "always") was 25.7, 26.7, and 44.1% for functional, emotional, and physical groups of sub-items respectively. GETS: the mean percentage of answers with a score ≥ 3 was 60.85%, significantly higher if compared with that of answers with a score < 3 (40.14%). The mean percentages of answers with a score 0-2, 3-4, and 5-7 were 40.1, 16.7, and 43.7% respectively. SOAL: a mean of 57.9% of answers gained a symptomatic score (1 ["a little"] or 2 ["a lot"]) and 41.9%, the score 0. The difference was statistically significant (p < 0.05). The first two most recurrent items with a score 2 ("a lot") were "Do you have a problem swallowing dry food?" (46%) and "Do you have a problem swallowing solid food?" (36%). The study represents the first to describe the globus pharyngeus symptoms in IM population. Moreover, it allows to confirm the recurrence of dysphonia and dysphagia in this type of patients. Particularly, it has been demonstrated that the alteration of swallowing function is related to solid and dry food. The self-assessment questionnaires proved as a useful tool to early detection of dysfunctions in order to avoid further deterioration of quality of life and to prevent serious life-threatening complications.


Assuntos
Transtornos de Deglutição/epidemiologia , Disfonia/epidemiologia , Psicometria , Doenças Reumáticas/fisiopatologia , Índice de Gravidade de Doença , Adulto , Estudos Transversais , Transtornos de Deglutição/diagnóstico , Disfonia/diagnóstico , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Doenças Reumáticas/complicações , Inquéritos e Questionários
16.
Rev. pesqui. cuid. fundam. (Online) ; 11(2, n. esp): 411-416, jan. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-969538

RESUMO

Objetivo: Caracterizar os aspectos sociodemográficos, organizacionais, estilo de vida, saúde-doença e vocais de professoras. Métodos: Estudo transversal e analítico envolvendo 146 docentes. Realizou-se análise bivariada por meio do teste qui-quadrado de Pearson. Resultados: A prevalência de alteração vocal crônica foi de 39,7%. As principais queixas autorreferidas foram: garganta seca, rouquidão, cansaço vocal, pigarro e falha na voz. Observou-se diferença estatisticamente significante para as variáveis: tempo de regência, ruído fora da escola, nenhum ou 1 copo de suco por dia, mais de uma dose alcoólica por vez, fala muito a demais no dia-a-dia, faltas e afastamento do trabalho por problema vocal, percepção de problema respiratório, diagnóstico médico de alergia respiratória, consulta médica para a voz e tratamento fonoaudiológico. Conclusão: Conhecer a prevalência e o perfil dos docentes com disfonia crônica são fatores importantes para atividades contínuas de promoção da saúde


Objective: The study's purpose has been to characterize the socio-demographic, organizational, lifestyle, health-disease and vocal aspects of teachers. Methods: It is both a cross-sectional and an analytical study that has involved 146 participating teachers. A bivariate analysis was performed through the Pearson's Chi-squared Test. Results: The prevalence of chronic vocal alteration was 39.7%. The main self-referred complaints were, as follows: dry throat, hoarseness, vocal fatigue, throat clearing and voice failure. A statistically significant difference was observed for the following variables: regency time, out-of-school noise, either none or one glass of juice per day, more than one alcoholic dose at a time, talks a lot on a daily basis, absences and work leave because of vocal issues, perception of respiratory problem, medical diagnosis of respiratory allergy, medical consultation for voice and speech-language therapy. Conclusion: Knowing both the prevalence and the profile of the chronic dysphonia bearing teachers are held as important factors for ongoing activities towards health promotion


Objetivo: Caracterizar los aspectos socio-demográficos, de organización, estilo de vida, salud-dolencia y vocales de las profesoras. Métodos: Estudio transversal y analítico involucrando 146 docentes. Se realizó un análisis bivariable por medio del test qui-cuadrado de Pearson. Resultados: Alteración vocal crónica 39,7%. Quejas autoreferidas: sequedad en la garganta, ronquera, cansancio vocal, irritación y fallo de la voz. Se observó una diferencia estadística significante para las variables: tiempo de desempeño, ruido fuera de la escuela, ningún ó 1 vaso de jugo diariamente, más de una dosis alcohólica al beber, hablar demasiado cotidianamente, faltas de descanso laboral por problema vocal, percepción del problema respiratorio, diagnóstico médico de alergia respiratoria, consulta médica para la voz y tratamiento fono-audiológico. Conclusión: Conocer el predominio y el perfil de docentes que padecen de disfonía crónica son factores importantes para las actividades continuadas de promoción de la salud


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Condições de Trabalho , Distúrbios da Voz , Docentes , Disfonia/prevenção & controle , Disfonia/epidemiologia , Riscos Ocupacionais , Saúde do Trabalhador
17.
Medicine (Baltimore) ; 97(49): e13552, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30544470

RESUMO

This research aims to explore the accurate incidence, severity and outcomes of dysphagia and dysphonia after Hangman fractures.A total of 93 patients were included in this study and clinical data were reviewed. The Bazaz grading system (0-None; 1-Mild; 2-Moderate; 3-Severe) was used for dysphagia evaluation and the Voice Handicap Index-10 used to evaluate dysphonia. In all of the patients, evaluation of dysphagia and dysphonia was performed preoperatively and at 1 week, 1 month, 3, 6, and 12 months after surgery. SPSS 22.0 software (SPSS Inc, Chicago, IL) was used for all statistical analyses.Posttraumatic immediate dysphagia was found in 8 patients and posttraumatic immediate dysphonia was observed in 3 patients. The incidence of dysphagia was 22.6% at the 1st week, 16.1% at the 1st month, and 9.7% at the 3rd month of follow-up. The incidence of dysphonia was 24.5% at the 1st week, 11.3% at the 1st month, and 3.8% at the 3rd month of follow-up.Posttraumatic immediate dysphagia and dysphonia occurred and the anterior surgical approach was associated with a higher incidence of dysphagia compared to posterior surgery and nonoperative patients. Most dysphagia and dysphonia were mild and gradually decreased during the subsequent 3 months after surgery. Future prospective, randomized studies with larger sample sizes are required to validate these data.


Assuntos
Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/etiologia , Disfonia/epidemiologia , Disfonia/etiologia , Fraturas da Coluna Vertebral/complicações , Fraturas da Coluna Vertebral/epidemiologia , Adolescente , Adulto , Idoso , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/lesões , Vértebras Cervicais/cirurgia , Transtornos de Deglutição/reabilitação , Disfonia/reabilitação , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/cirurgia , Adulto Jovem
18.
Psychiatr Q ; 89(3): 621-629, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29404831

RESUMO

The construct of dysphoria has been described inconsistently across a broad range of psychopathology. The term has been used to refer to an irritable state of discontent, but is also thought to incorporate anger, resentment and nonspecific symptoms associated with anxiety and depression, such as tension and unhappiness. The Nepean Dysphoria Scale has been developed to allow assessment of dysphoria, but its factor structure has not yet been investigated in clinical samples. We aimed to determine the latent structure of dysphoria as reflected by the Nepean Dysphoria Scale, using a clinical sample. Adults (N = 206) seeking treatment at a range of mental health services were administered the Nepean Dysphoria Scale. Four putative factor structures were investigated using confirmatory factor analysis: a single-factor model, a hierarchical model, a bifactor model and a four-factor model as identified in previous studies. No model fit the data except for a four-factor model when a revised 22-item version of the original 24-item scale was investigated. A four-factor structure similar to that identified in non-clinical samples was supported, albeit following the removal of two items. The Nepean Dysphoria Scale appears to have utility for the assessment of dysphoria in routine clinical settings.


Assuntos
Disfonia/diagnóstico , Disfonia/epidemiologia , Análise Fatorial , Índice de Gravidade de Doença , Adulto , Distribuição de Qui-Quadrado , Disfonia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Escalas de Graduação Psiquiátrica , Reprodutibilidade dos Testes
19.
Rev. bras. med. trab ; 15(4): 324-328, out.-dez. 2017.
Artigo em Inglês, Português | LILACS | ID: biblio-876752

RESUMO

Contexto: A voz é uma importante ferramenta de trabalho para professores. Esses profissionais são frequentemente afastados da docência por distúrbios vocais, repercutindo no grande número de licença médica, restrição de função e readaptação profissional. Objetivo: Avaliar o perfil epidemiológico de professores afastados por distúrbios vocais e a repercussão da disfonia na diminuição das atividades laborais, na restrição de função e na readaptação profissional. Métodos: Estudo retrospectivo realizado entre janeiro de 2009 e dezembro de 2010, a partir da coleta de dados de prontuários da Secretaria de Estado de Educação do Distrito Federal, sobre os professores afastados por período superior a 30 dias. Resultados: Foram analisados 153 professores afastados por disfonia. A maior prevalência de distúrbios vocais ocorreu no gênero feminino (96,7%). Os nódulos vocais predominam no diagnóstico, representando 40% das lesões vocais encontradas. O tempo médio de afastamento foi de 120 dias. Aproximadamente 55% dos professores em licença médica estavam em restrição de função e ficaram em média 166 dias nessa condição. Ao todo, 25,5% dos professores foram readaptados e 73,8% retornaram à sala de aula. Conclusão: Adoecimento vocal é uma causa frequente de afastamento profissional, gerando grandes gastos anuais. Medidas preventivas e a consolidação de orientações quanto ao uso vocal reduziriam significativamente o número de professores em restrição ou readaptação de função.


Background: Voice is an important working tool for teachers. These professionals often stay away from work due to voice disorders, resulting in a high frequency of sick leave, function restriction and professional re-adaptation. Objective: To evaluate the epidemiological profile of teacher absenteeism due to voice disorders and the impact of dysphonia in reducing labor activities, function restriction and professional re-adaptation. Methods: A retrospective study of teachers away from work for more than 30 days was performed from January 2009 to December 2010 based on data collected from medical records at State Secretariat for Education, Federal District, Brazil. Results: A total of 153 teachers away from work due to dysphonia were analyzed. The highest prevalence of voice disorders was found among women (96.7%). Vocal nodules were the most prevalent diagnosis, corresponding to 40% of vocal lesions. The average time away from work was 120 days. About 55% of the teachers on sick leave exhibited function restriction and remained in that condition for 166 days, on average. In total, 25.5% of the teachers needed re-adaptation, and 73.8% were able to return to the classroom. Conclusion: Voice disorders are a frequent cause of sick leave, resulting in a high annual cost. Preventive measures and vocal orientation would significantly reduce the number of teachers with function restriction or requiring re-adaptation.


Assuntos
Distúrbios da Voz/epidemiologia , Licença Médica , Disfonia/epidemiologia , Doenças Profissionais , Doenças Profissionais/prevenção & controle , Brasil , Estudos Retrospectivos
20.
PLoS One ; 12(8): e0182286, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28783741

RESUMO

BACKGROUND: Sleep is important in terms of good general health and appropriate sleep duration has been linked to quality-of-life. Dysphonia may impair communication and social relationships, and is thus also closely related to quality-of-life. No large-scale, cross-sectional epidemiological study of a sample representative of the population of an entire country has yet assessed the possible existence of a relationship between sleep duration and dysphonia. METHODS: We investigated a possible association between subjective voice problems and self-reported sleep duration in South Korean subjects using 2010-2012 data from the Korean National Health and Nutrition Examination Survey (KNHANES). Cross-sectional data on 17,806 adults (7,578 males and 10,228 females) over the age of 19 years who completed the KNHANES were analyzed. All participants reported voice problems (if present) and their daily average sleep duration using a self-reporting questionnaire. Sleep duration was classified into five categories as follows: ≤5, 6, 7, 8, and ≥9 h/day. RESULTS: The overall prevalence of dysphonia was 6.8%; 5.7% in males and 7.7% in females. The prevalence for dysphonia by sleep duration exhibited a U-shape, with the lowest point being at sleep duration of 7-8h. After adjustment for covariates (age, sex, smoking status, alcohol consumption, regular exercise, low income, high-level education), a sleep duration of ≤5 h (OR = 1.454; 95% CI, 1.153-1.832) and a sleep duration of ≥9 h (OR = 1.365; 95% CI, 1.017-1.832) were significantly associated with dysphonia, compared to a sleep duration of 7 h. In terms of gender, males who slept for ≥9 h were at a 2-fold (OR = 2.028; 95% CI, 1.22-3.35) higher odds for dysphonia (p<0.05) compared to those who slept for 7 h. A sleep duration ≤5 h was associated with a 1.6-fold (OR = 1.574; 95% CI, 1.203-2.247) higher odds of dysphonia ≥3 weeks in duration (long-term dysphonia). CONCLUSIONS: This is the first study to show that both short and long sleep duration were significantly associated with the development of dysphonia. The association between sleep duration and dysphonia was more marked in males than females. A sleep duration ≤5 h had a significant impact on the prevalence of long-term dysphonia.


Assuntos
Disfonia/fisiopatologia , Inquéritos Epidemiológicos , Inquéritos Nutricionais , Sono , Estudos Transversais , Disfonia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia
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