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1.
Rev Neurosci ; 32(3): 351-361, 2021 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-33618441

RESUMO

The ongoing pandemic of Coronavirus disease 2019 (COVID-19) has infected more than 27 million confirmed cases and 8,90,000 deaths all around the world. Verity of viral infections can infect the nervous system; these viral infections can present a wide range of manifestation. The aim of the current study was to systematically review the COVID-19 associated central nervous system manifestations, mental and neurological symptoms. For that we conducted a comprehensive systematic literature review of four online databases, including Web of Science, PubMed, Scopus and Embase. All relevant articles that reported psychiatric/psychological symptoms or disorders in COVID-19 without considering time and language restrictions were assessed. All the study procedures were performed based on the PRISMA criteria. Due to the screening, 14 studies were included. The current study result indicated that, the pooled prevalence of CNS or mental associated disorders with 95% CI was 50.68% (6.68-93.88). The most prevalence symptoms were hyposmia/anosmia/olfactory dysfunction (number of study: 10) with 36.20% (14.99-60.51). Only one study reported numbness/paresthesia and dysphonia. Pooled prevalence of numbness/paresthesia and dysphonia was 5.83% (2.17-12.25) and 2.39% (10.75-14.22). The pooled prevalence of depression and anxiety was 3.52% (2.62-4.54) and 13.92% (9.44-19.08). Our findings demonstrate that COVID-19 has a certain relation with neurological symptoms. The hypsomia, anosmia or olfactory dysfunction was most frequent symptom. Other symptoms were headache or dizziness, dysgeusia or ageusia, dysphonia and fatigue. Depression, anxiety, and confusion were less frequent symptoms.


Assuntos
/epidemiologia , Ansiedade/epidemiologia , Depressão/epidemiologia , /fisiopatologia , Ansiedade/psicologia , Depressão/psicologia , Disgeusia/epidemiologia , Disgeusia/fisiopatologia , Disfonia/epidemiologia , Disfonia/fisiopatologia , Fadiga/epidemiologia , Fadiga/fisiopatologia , Cefaleia/epidemiologia , Cefaleia/fisiopatologia , Humanos , Hipestesia/epidemiologia , Hipestesia/fisiopatologia , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/fisiopatologia , Parestesia/epidemiologia , Parestesia/fisiopatologia , Prevalência
2.
BMJ Case Rep ; 14(2)2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33526525

RESUMO

We present a case of multifocal laryngotracheal amyloidosis (LTA) in a 43-year-old man with persistent and progressive dysphonia and dyspnoea, and a first inconclusive histology. Although laryngeal amyloidosis accounts for fewer than 1% of all benign laryngeal tumours, it is in fact the most common site of amyloid deposition in the head, neck and respiratory tract. The clinical scenario is non-specific and diagnosis depends on a high degree of suspicion and on histology. Imaging is useful in mapping lesions, which are often more extensive than they appear during laryngoscopy. Despite being a benign entity, the prognosis is variable with a high-rate and long-latency recurrences, requiring long-term follow-up.


Assuntos
Amiloidose de Cadeia Leve de Imunoglobulina/diagnóstico , Doenças da Laringe/diagnóstico por imagem , Doenças da Traqueia/diagnóstico por imagem , Adulto , Broncoscopia , Disfonia/fisiopatologia , Dispneia/fisiopatologia , Humanos , Amiloidose de Cadeia Leve de Imunoglobulina/patologia , Amiloidose de Cadeia Leve de Imunoglobulina/fisiopatologia , Doenças da Laringe/patologia , Doenças da Laringe/fisiopatologia , Laringoscopia , Masculino , Tomografia Computadorizada por Raios X , Doenças da Traqueia/patologia , Doenças da Traqueia/fisiopatologia
4.
Medicine (Baltimore) ; 99(39): e22236, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991418

RESUMO

Articulation disorder is associated with impaired control of respiration and speech organ movement. There are many cases of dysarthria and dysphonia in stroke patients. Dysphonia adversely affects communication and social activities, and it can interfere with everyday life. The purpose of this study is to assess the association between phonation abilities and the vowel quadrilateral in stroke patients.The subjects were stroke patients with pronunciation and phonation disorders. The resonance frequency was measured for the 4 corner vowels to measure the vowel space area (VSA) and formant centralization ratio (FCR). Phonation ability was evaluated by the Dysphonia Severity Index (DSI) and maximal phonation time (MPT) through acoustic evaluation for each vowel. Pearsons correlation analysis was performed to confirm the association, and multiple linear regression analysis was performed between variables.The correlation coefficients of VSA and MPT/u/ were 0.420, VSA and MPT/i/ were 0.536, VSA and DSI/u/ were 0.392, VSA and DSI /i/ were 0.364, and FCR and DSI /i/ were -0.448. Multiple linear regression analysis showed that VSA was a factor significantly influencing MPT/u/ (ß = 0.420, P = .021, R = 0.147), MPT/i/ (ß = 0.536, P = .002, R = 0.262), DSI/u/ (ß = 0.564, P = .045, R = 0.256), and DSI/i/ (ß = 0.600, P = .03, R = 0.302).The vowel quadrilateral can be a useful tool for evaluating the phonation function of stroke patients.


Assuntos
Disfonia/terapia , Fonação , Reabilitação do Acidente Vascular Cerebral/métodos , Idoso , Disfonia/etiologia , Disfonia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Acidente Vascular Cerebral/complicações
5.
PLoS One ; 15(7): e0236009, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32658934

RESUMO

Mild Cognitive Impairment (MCI) is a syndrome characterized by cognitive decline greater than expected for an individual's age and education level. This study aims to determine whether voice quality and speech fluency distinguish patients with MCI from healthy individuals to improve diagnosis of patients with MCI. We analyzed recordings of the Cookie Theft picture description task produced by 26 patients with MCI and 29 healthy controls from Sweden and calculated measures of voice quality and speech fluency. The results show that patients with MCI differ significantly from HC with respect to acoustic aspects of voice quality, namely H1-A3, cepstral peak prominence, center of gravity, and shimmer; and speech fluency, namely articulation rate and averaged speaking time. The method proposed along with the obtainability of connected speech productions can enable quick and easy analysis of speech fluency and voice quality, providing accessible and objective diagnostic markers of patients with MCI.


Assuntos
Disfunção Cognitiva/epidemiologia , Disfonia/fisiopatologia , Fala/fisiologia , Qualidade da Voz/fisiologia , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Incidência , Masculino , Suécia/epidemiologia
6.
Sci Rep ; 10(1): 10179, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-32576918

RESUMO

Adductor-type spasmodic dysphonia (ADSD) manifests in effortful speech temporarily relievable by botulinum neurotoxin type A (BoNT-A). Previously, abnormal structure, phonation-related and resting-state sensorimotor abnormalities as well as peripheral tactile thresholds in ADSD were described. This study aimed at assessing abnormal central tactile processing patterns, their spatial relation with dysfunctional resting-state connectivity, and their BoNT-A responsiveness. Functional MRI in 14/12 ADSD patients before/under BoNT-A effect and 15 controls was performed (i) during automatized tactile stimulus application to face/hand, and (ii) at rest. Between-group differential stimulation-induced activation and resting-state connectivity (regional homogeneity, connectivity strength within selected sensory(motor) networks), as well as within-patient BoNT-A effects on these differences were investigated. Contralateral-to-stimulation overactivity in ADSD before BoNT-A involved primary and secondary somatosensory representations, along with abnormalities in higher-order parietal, insular, temporal or premotor cortices. Dysphonic impairment in ADSD positively associated with left-hemispheric temporal activity. Connectivity was increased within right premotor (sensorimotor network), left primary auditory cortex (auditory network), and regionally reduced at the temporoparietal junction. Activation/connectivity before/after BoNT-A within-patients did not significantly differ. Abnormal ADSD central somatosensory processing supports its significance as common pathophysiologic focal dystonia trait. Abnormal temporal cortex tactile processing and resting-state connectivity might hint at abnormal cross-modal sensory interactions.


Assuntos
Disfonia/fisiopatologia , Distúrbios Distônicos/fisiopatologia , Células Receptoras Sensoriais/fisiologia , Toxinas Botulínicas Tipo A/uso terapêutico , Mapeamento Encefálico/métodos , Disfonia/tratamento farmacológico , Distúrbios Distônicos/tratamento farmacológico , Feminino , Mãos/fisiopatologia , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Córtex Motor/efeitos dos fármacos , Córtex Motor/fisiopatologia , Fonação/efeitos dos fármacos , Fonação/fisiologia , Células Receptoras Sensoriais/efeitos dos fármacos , Fala/efeitos dos fármacos , Fala/fisiologia
7.
Am J Otolaryngol ; 41(4): 102455, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32475619

RESUMO

BACKGROUND: There are no reliable outcome predictors for functional dysphonia (FD) patients. OBJECTIVES: To investigate if any clinical or phoniatric characteristics could identify FD patients at risk of negative outcome after speech therapy. METHODS: We retrospectively reviewed the results of 78 FD patients treated with the proprioceptive elastic method. Before and one-month after therapy, patients underwent endoscopy, acoustic analysis with Multi-Dimensional Voice Program, and Voice Handicap Index-10 questionnaire (VHI-10). Negative outcome was the persistence of VHI-10 ≥ 13. RESULTS: 26 FD patients had negative outcome (i.e. VHI-10 ≥ 13) after speech therapy. At univariate analysis, clinical variables (i.e. sex, age, comorbidities, dysphonia duration, and professional voice use) were not associated with the outcome. Elevated Jitter% (Jitt; p = 0.03), Shimmer% (Shim; statistical trend, p = 0.06), and Noise to Harmonics Ratio (statistical trend, p = 0.06) were found in patients with poor results. At multivariate analysis, higher Jitt was an independent negative prognostic factor (p = 0.02), while a statically trend was identified for Shim (p = 0.06). A panel of Jitt >1.5 and Shim >5.1 showed an acceptable discriminatory power (AUC [ROC] = 0.76) according to Hosmer and Lemeshow scale. CONCLUSION: A panel of two acoustic analysis parameters could help in identifying FD patients at risk of speech therapy failure. Further studies in these patients are needed to evaluate the most efficient treatment protocol.


Assuntos
Disfonia/diagnóstico , Disfonia/reabilitação , Fonação , Acústica da Fala , Medida da Produção da Fala/métodos , Fonoterapia/métodos , Falha de Tratamento , Qualidade da Voz , Voz , Adulto , Disfonia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Risco
8.
Muscle Nerve ; 62(2): 258-261, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32447763

RESUMO

BACKGROUND: Patients with myasthenia gravis (MG) may experience worsening symptoms outside of a clinical setting. A method of diagnosing and triaging such individuals would be valuable. This study gauged the viability of a nurse-administered single breath count test (SBCT) over the telephone for assessing MG exacerbations. METHODS: This was a retrospective, single-center review of a pilot study of 45 telephone calls from patients with MG who had worsening baseline symptoms. SBCTs were administered over the telephone to patients by trained nurses. Patients with a breath count of 25 or less were sent to the emergency department. RESULTS: Using a cutoff count of 25, the nurse-administered telephonic SBCT had a positive predictive value of 71%, sensitivity of 80%, and specificity of 60% in diagnosing an MG exacerbation. CONCLUSIONS: SBCT administered by trained nurses by means of telephone may be a useful screening tool for assessing decreased respiratory function in patients with MG.


Assuntos
Dispneia/fisiopatologia , Miastenia Gravis/diagnóstico , Testes de Função Respiratória/métodos , Exacerbação dos Sintomas , Telefone , Adolescente , Adulto , Idoso , Transtornos de Deglutição/fisiopatologia , Progressão da Doença , Disartria/fisiopatologia , Disfonia/fisiopatologia , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Miastenia Gravis/fisiopatologia , Enfermeiras e Enfermeiros , Projetos Piloto , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
9.
Brain Stimul ; 13(3): 908-915, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32289724

RESUMO

BACKGROUND: Reduced intracortical inhibition is a neurophysiologic finding in focal dystonia that suggests a broader problem of impaired cortical excitability within the brain. A robust understanding of the neurophysiology in dystonia is essential to elucidate the pathophysiology of the disorder and develop new treatments. The cortical silent period (cSP) is a reliable, non-invasive method to measure intracortical inhibition in the primary motor cortex associated with a muscle of interest. In adductor spasmodic dysphonia (AdSD), cSP of the laryngeal motor cortex (LMC) which directly corresponds to the affected musculature, the thyroarytenoid (TA), has not been examined. OBJECTIVE: This work evaluated the cSP of the LMC and the relationship between cSP and functional magnetic resonance imaging (fMRI) blood-oxygen-level dependent (BOLD) activation in people with AdSD (n = 12) compared to healthy controls (CTL, n = 14). RESULTS: Shortened LMC cSP were observed bilaterally in people with AdSD vs CTL (F(1, 99) = 19.5226, p < 0.0001), with a large effect size (η2 = 0.1834). Between-group fMRI analysis revealed greater activation in bilateral LMC in the AdSD > CTL contrast as compared to CTL > AdSD contrast. Correlation analysis showed that people with AdSD have positive correlation of left LMC BOLD activation and the cSP. Further, the right LMC cSP lacks either positive or negative associations with BOLD activation. CTL individuals displayed both positive and negative correlations between cSP and BOLD activation in the left LMC. In CTL, the LMC cSP and BOLD activation showed exclusively negative correlations in both hemispheres. CONCLUSION: In AdSD, the cortical activation during phonation may not be efficiently or effectively associated with inhibitory processes, leading to muscular dysfunction. These findings may give insight into the maladaptive cortical control during phonation in people with AdSD.


Assuntos
Disfonia/diagnóstico por imagem , Disfonia/terapia , Imagem por Ressonância Magnética/métodos , Córtex Motor/diagnóstico por imagem , Fonação/fisiologia , Estimulação Magnética Transcraniana/métodos , Adulto , Idoso , Disfonia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Córtex Motor/fisiopatologia
10.
Muscle Nerve ; 62(2): 201-207, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32270505

RESUMO

INTRODUCTION: In this study we aimed to document the prevalence and age of onset of motor impairments and other key symptoms in oculopharyngeal muscular dystrophy (OPMD). METHODS: Retrospective chart review of patients followed at the Saguenay Neuromuscular Clinic (Quebec, Canada). RESULTS: A total of 333 participants with the (GCN)13 mutation were included. Before the age of 75 years, 27% of them had walking limitations, 14% could not climb stairs independently, and 14% used a wheelchair for long distances or daily living. The median age of onset was 54 years for ptosis and dysphagia and 58 years for lower limb proximal weakness. Other frequent symptoms included fatigue, pharyngeal pooling of thickened secretions, and dysphonia. The median age at death was 77 years and the main cause was respiratory disease. DISCUSSION: This study provides important information to help anticipatory guidance for affected people and for the development of therapeutic trials in OPMD.


Assuntos
Atividades Cotidianas , Blefaroptose/fisiopatologia , Transtornos de Deglutição/fisiopatologia , Disfonia/fisiopatologia , Fadiga/fisiopatologia , Limitação da Mobilidade , Debilidade Muscular/fisiopatologia , Distrofia Muscular Oculofaríngea/fisiopatologia , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Creatina Quinase/sangue , Progressão da Doença , Eletromiografia , Feminino , Humanos , Extremidade Inferior , Masculino , Pessoa de Meia-Idade , Distrofia Muscular Oculofaríngea/sangue , Distrofia Muscular Oculofaríngea/genética , Proteína I de Ligação a Poli(A)/genética , Estudos Retrospectivos , Taxa de Sobrevida , Expansão das Repetições de Trinucleotídeos , Cadeiras de Rodas
11.
Rev. logop. foniatr. audiol. (Ed. impr.) ; 40(1): 30-44, ene.-mar. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193619

RESUMO

ANTECEDENTES Y OBJETIVO: La presbifonía aparece en personas mayores a causa del envejecimiento de las cuerdas vocales. Normalmente, la sintomatología comienza entre los 60-65 años, aunque puede aparecer antes, en torno a los 55 años. Es importante abordar a tiempo esta enfermedad, ya que la función vocal, y como consecuencia la calidad de vida de los pacientes, puede mejorar aplicando alguna de las diferentes técnicas de rehabilitación existentes. Un estudio reciente señala la relación entre padecer presbifonía y los problemas de depresión, soledad y aislamiento social. El objetivo de este trabajo es revisar los estudios acerca de la eficacia de los tratamientos para la presbifonía en la población que envejece. MÉTODO: Se realizó una búsqueda de estudios publicados en diferentes bases de datos entre enero de 2008 y abril de 2018. RESULTADOS: Se seleccionaron 20 estudios que cumplían con los criterios de selección. Los resultados de la búsqueda señalan que los tratamientos utilizados en pacientes con presbifonía mejoran cualitativa y cuantitativamente su calidad vocal. La técnica más usada es la terapia de la voz, aunque en muchas ocasiones se complementa con otras técnicas médicas, como son la inyección y la cirugía de tiroplastia bilateral. CONCLUSIONES: Es necesario impulsar la investigación de esta enfermedad, ya que existe un número reducido de estudios y la muestra de estos es pequeña. En Europa no se han publicado estudios sobre tratamientos eficaces para la presbifonía en personas mayores. Resultan necesarios protocolos en atención primaria de detección y tratamiento de este problema en la población mayor para mejorar la calidad de vida de las personas que lo sufran


BACKGROUND AND OBJECTIVE: Presbyphonia appears in elderly people due to aging of the vocal cords. Normally, symptoms start between the ages of 60 and 65, although they can appear earlier at around 55. It is important to address this pathology promptly, since vocal function and, as a consequence, the quality of life of these patients can be improved by applying some of the different rehabilitation techniques available. The objective of this paper is to review the studies on the efficacy of treatments for presbyphonia in the elderly population. METHOD: A search was made of studies published in different databases between January 2008 and April 2018. RESULTS: Twenty studies were selected that met the selection criteria. The results of the search indicate that the treatments used in patients with presbyphonia improve vocal quality qualitatively and quantitatively. The most used technique is voice therapy, although in many cases it is complemented by other medical techniques such as injection and bilateral thyroplasty surgery. CONCLUSIONS: It is necessary to promote investigation of this pathology, since there are few studies and their samples are small. In Europe, no studies on effective treatment for presbyphonia in the elderly have been published. Protocols are needed in primary care to detect and treat this problem in the elderly, to improve the quality of life of people who suffer it


Assuntos
Humanos , Idoso , Envelhecimento/fisiologia , Disfonia/fisiopatologia , Disfonia/cirurgia
12.
Biomed Res Int ; 2020: 4208189, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32090091

RESUMO

Instrument-assisted measuring procedures expand the options within phoniatric diagnostics by quantifying the condition of the voice. The aim of this study was to examine objective treatment-associated changes of the recently developed vocal extent measure (VEM) and the established dysphonia severity index (DSI) in relation to subjective tools, i.e., self-evaluation via voice handicap index (VHI-12) and external evaluation via auditory-perceptual assessment of hoarseness (H). The findings for H (3 raters' group assessment), VHI-12, DSI, and VEM in 152 patients of both sexes (age range 16-75 years), taken before and 3 months after phonosurgery or vocal exercises, were compared and correlated. Posttherapeutically, all of the recorded parameters improved (p < 0.001). The degree of H reduced on average by 0.5, the VHI-12 score sank by 5 points, while DSI and VEM rose by 1.5 and 19, respectively. The correlations of these changes were significant but showed gradual differences between H and VHI-12 (r = 0.3), H and DSI (r = -0.3), and H and VEM (r = -0.4). We conclude that all investigated parameters are adequate to verify therapeutic outcomes but represent different dimensions of the voice. However, changes in the degree of H as gold standard were best recognized with the new VEM.


Assuntos
Acústica , Técnicas e Procedimentos Diagnósticos , Monitorização Fisiológica , Prega Vocal/fisiopatologia , Prega Vocal/cirurgia , Adolescente , Adulto , Idoso , Disfonia/diagnóstico , Disfonia/fisiopatologia , Feminino , Humanos , Laringe/fisiopatologia , Laringe/cirurgia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Resultado do Tratamento , Voz/fisiologia , Adulto Jovem
13.
J Speech Lang Hear Res ; 63(2): 405-420, 2020 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-32013664

RESUMO

Purpose This study examined vocal hyperfunction (VH) using voice onset time (VOT). We hypothesized that speakers with VH would produce shorter VOTs, indicating increased laryngeal tension, and more variable VOTs, indicating disordered vocal motor control. Method We enrolled 32 adult women with VH (aged 20-74 years) and 32 age- and sex-matched controls. All were speakers of American English. Participants produced vowel-consonant-vowel combinations that varied by vowel (ɑ/u) and plosive (p/b, t/d, k/g). VOT-measured at the release of the plosive to the initiation of voicing-was averaged over three repetitions of each vowel-consonant-vowel combination. The coefficient of variation (CoV), a measure of VOT variability, was also computed for each combination. Results The mean VOTs were not significantly different between the two groups; however, the CoVs were significantly greater in speakers with VH compared to controls. Voiceless CoV values were moderately correlated with clinical ratings of dysphonia (r = .58) in speakers with VH. Conclusion Speakers with VH exhibited greater variability in phonemic voicing targets compared to vocally healthy speakers, supporting the hypothesis for disordered vocal motor control in VH. We suggest future work incorporate VOT measures when assessing auditory discrimination and auditory-motor integration deficits in VH.


Assuntos
Disfonia/fisiopatologia , Adulto , Idoso , Estudos de Casos e Controles , Disfonia/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Fonética , Índice de Gravidade de Doença , Voz/fisiologia , Adulto Jovem
14.
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
15.
J Voice ; 34(1): 160.e7-160.e14, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30025623

RESUMO

BACKGROUND: The objective of this study was to explore the effectiveness of the five-week Novafon local vibration voice therapy (NLVVT) program with and without Novafon local vibration for dysphonia treatment. METHODS: Twenty-two voice-disordered subjects were divided into two groups. The intervention group (IG) performed the NLVVT program and the control group (CG) had the same voice exercises of this program without local vibration. RESULTS: After NLVVT, the IG showed significantly high results in all parameters of acoustics, multiparametric indices, and self-evaluation (all P values < 0.01). The CG revealed mostly much significantly lower results (P values < 0.05) or nonsignificant results for these parameters after the treatment. The intergroup comparison under consideration before and after NLVVT showed a large and significant treatment effect in voice quality (ie, narrowband spectrograms, and Acoustic Voice Quality Index), in which the IG had better treatment results. The aerodynamic measurement showed no significant changes for both groups after NLVVT (P value > 0.05). CONCLUSION: After the NLVVT program both groups showed significant improvements of various voice measurements, in which the IG revealed better treatment results than the CG. However, next to voice exercises an extra benefit for local vibration with the Novafon appliance was assessed in voice quality.


Assuntos
Disfonia/terapia , Vibração/uso terapêutico , Qualidade da Voz , Treinamento da Voz , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Disfonia/diagnóstico , Disfonia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recuperação de Função Fisiológica , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
16.
J Voice ; 34(1): 160.e15-160.e23, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30055984

RESUMO

PURPOSE: The purpose of the current study is to determine the relation of frailty syndrome to acoustic measures of voice quality and voice-related handicap. METHODS: Seventy-three adults (52 community-dwelling participants and 21 assisted living residents) age 60 and older completed frailty screening, acoustic assessment, cognitive screening, and the Voice Handicap Index-10 (VHI-10). Factor analysis was used to consolidate acoustic measures. Statistical analysis included multiple regression, analysis of variance, and Tukey post-hoc tests with alfa of 0.05. RESULTS: Montreal Cognitive Assessment (MoCA) and exhaustion explained 28% of the variance in VHI-10. MoCA and sex explained 27% of the variance in factor 1 (spectral ratio), age and MoCA explained 13% of the variance in factor 2 (cepstral peak prominence for speech), and slowness explained 10% of the variance in factor 3 (cepstral peak prominence for sustained /a/). There were statistically significant differences in two measures across frailty groups: VHI-10 and MoCA. Acoustic factor scores did not differ significantly among frailty groups (P > 0.05). CONCLUSIONS: Voice-related handicap and cognitive status differed among robust and frail older adults, yet vocal function measures did not. The components of frailty most related to VHI-10 were exhaustion and weight loss rather than slowness, weakness, or inactivity. Based on these findings, routine screening of physical frailty and cognition are recommended as part of a complete voice evaluation for older adults.


Assuntos
Cognição , Disfonia/diagnóstico , Fragilidade/diagnóstico , Avaliação Geriátrica , Qualidade da Voz , Acústica , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Avaliação da Deficiência , Disfonia/fisiopatologia , Disfonia/psicologia , Feminino , Fragilidade/fisiopatologia , Fragilidade/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular , Debilidade Muscular/diagnóstico , Debilidade Muscular/fisiopatologia , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Comportamento Sedentário , Medida da Produção da Fala , Perda de Peso
17.
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
18.
J Voice ; 34(1): 145-149, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30172670

RESUMO

OBJECTIVES/HYPOTHESIS: Medialization thyroplasty (MT) has become a prominent method for treating glottal insufficiency. This study aimed to visualize the biomechanical influence of a medialization implant on arytenoid cartilage, particularly on the length and level of paralyzation in the vocal fold, in patients with unilateral vocal fold paralysis. STUDY DESIGN: Prospective study. METHODS: We recruited 15 patients (10 men, 5 women) with unilateral vocal fold paralysis that underwent MT with a Montgomery® thyroplasty implant. We performed high-resolution computed tomography of the arytenoid cartilage before and after MT and analyzed the three-dimensional images. To visualize the movement of the arytenoid and to measure the lengthening of the vocal fold, we superimposed pre- and postoperative 3D images with MIMICS software. RESULTS: On the affected side, the implant pushed the arytenoid backwards. In addition, the vocal process of the arytenoid was inwardly rotated. These movements resulted in an elongated, augmented vocal fold on the affected side. CONCLUSION: MT led to an elongated, medialized vocal fold on the treated side. After the intervention, the vocal folds on both sides were the same length in the phonatory position.


Assuntos
Cartilagem Aritenoide/fisiopatologia , Disfonia/cirurgia , Laringoplastia/instrumentação , Fonação , Paralisia das Pregas Vocais/cirurgia , Prega Vocal/cirurgia , Qualidade da Voz , Idoso , Cartilagem Aritenoide/diagnóstico por imagem , Fenômenos Biomecânicos , Disfonia/diagnóstico por imagem , Disfonia/fisiopatologia , Feminino , Humanos , Laringoplastia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Recuperação de Função Fisiológica , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Paralisia das Pregas Vocais/diagnóstico por imagem , Paralisia das Pregas Vocais/fisiopatologia , Prega Vocal/diagnóstico por imagem , Prega Vocal/fisiopatologia
19.
J Voice ; 34(1): 127-129, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30174222

RESUMO

OBJECTIVE: To discuss the utility and outcomes of bilateral myoneurectomy for treatment of abductor spasmodic dysphonia. METHODS: Bilateral myoneurectomy is a known treatment option for patients with adductor spasmodic dysphonia. Its use for treatment of abductor spasmodic dysphonia, however, has not been documented previously. In this case report, treatment and long-term outcomes of abductor spasmodic dysphonia with bilateral myoneurectomy are discussed. RESULTS: A 50-year-old male presented with abductor spasmodic dysphonia. His initial Voice Handicap Index-10 (VHI-10) score was 29, and he had breathy breaks during 60 series. He had no improvement in vocal quality after 6 botulinum toxin injections over 21 months. He underwent staged bilateral posterior cricoarytenoid partial myoneurectomy, with the left posterior cricoarytenoid myoneurectomy performed 33 months after presentation and right posterior cricoarytenoid myectomy 11 months later. Eight years postoperatively, his VHI-10 score was 12. During postoperative 60 series, the patient demonstrated few breathy breaks. Overall, the patient reports improved quality of life and satisfaction with his voice. CONCLUSION: This is the first report of a long-term follow-up data for bilateral, endoscopic, partial posterior cricoarytenoid muscle myoneurectomy to treat refractory abductor spasmodic dysphonia. Long-term VHI-10 results suggest improvement of symptoms, despite mild difficulty with 60 series. While botulinum toxin therapy is the mainstay of management for abductor spasmodic dysphonia, surgical treatment is a potential alternative at least for refractory cases.


Assuntos
Disfonia/cirurgia , Músculos Laríngeos/cirurgia , Laringoscopia , Qualidade da Voz , Disfonia/diagnóstico , Disfonia/etiologia , Disfonia/fisiopatologia , Humanos , Músculos Laríngeos/fisiopatologia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Recuperação de Função Fisiológica , Resultado do Tratamento
20.
J Voice ; 34(1): 158.e1-158.e7, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30205918

RESUMO

OBJECTIVE: The objective of this study was to validate the Vocal Tract Discomfort Scale (VTD) Argentine version. STUDY DESIGN: Nonrandomized, cross-sectional prospective study with control group. MATERIAL AND METHODS: The VTD Scale was culturally and linguistically adapted to Argentinian Spanish according to the recommended requirements of translation, closely observing the methodology that was suggested (translation, summary, review and back-translation). The scale Argentine version (Escala de disconfort del tracto vocal) was administered to 107 patients with muscle-tension dysphonia (MTD) (23 men and 84 women, mean ages being: 32.30 ± 9.09 years old for MTD type I, and 31.23 ± 8.45 years old for MTD type II) and 30 volunteers with no vocal pathology (9 men and 21 women, mean ages being: 44.3 ± 8.72 years old). All patients completed the Escala de disconfort del tracto vocal before and after Mathieson Laryngeal Manual Therapy. The results of the VTD Scale administered in both patients and vocally healthy subjects were initially compared; the changes arising from pre and post therapy were also compared in the second phase. The internal consistency of the VTD Scale was assessed using Cronbach alpha coefficient. RESULTS: The internal consistency assessed was considered acceptable for both subscales within the VTD Scale. The values obtained for frequency, severity, and total score of the Scale were similar in patients with MTD I and MTD II, marking a difference with those obtained in the control group of healthy volunteers. A lump feeling in the throat was one of the most frequent symptoms in both MTD and vocally healthy groups. CONCLUSION: The VTD Scale shows an acceptable consistency, so it is a highly reproducible, reliable, and valuable instrument of evaluation to assess Argentinian patients with voice disorders.


Assuntos
Autoavaliação Diagnóstica , Disfonia/diagnóstico , Prega Vocal/fisiopatologia , Qualidade da Voz , Adulto , Argentina , Percepção Auditiva , Estudos Transversais , Disfonia/fisiopatologia , Disfonia/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Adulto Jovem
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