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1.
Ann Otol Rhinol Laryngol ; 130(1): 47-55, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32627613

RESUMO

OBJECTIVES: The primary objectives were to report oncologic outcomes of transoral laser microsurgery with potassium-titanyl-phosphate (KTP) laser (TLM-KTP) ablation of early glottic cancer (EGC). The secondary objectives were to report vocal outcomes and to analyze factors that might influence outcomes. METHODS: A multi-institutional, retrospective analysis of consecutive patients treated for T1 or T2 glottic squamous cell carcinoma undergoing TLM-KTP ablation with at least 2 years of follow-up was performed. Patients with prior radiation or surgery for laryngeal disease were excluded. PRIMARY OUTCOME MEASURES INCLUDED: surgical failures requiring radiation or laryngectomy, disease-specific survival (DSS), and overall survival (OS). Secondary outcome measures included: pre- and postoperative Voice Handicap Index-10 (VHI-10) scores. The effects of smoking status, stage, and anterior commissure involvement on outcomes were analyzed. RESULTS: Overall 88 patients met inclusion criteria (83% male, 79.5% current or former smokers). Mean age was 68 (standard deviation (SD): 12). Mean follow-up was 39.5 months (SD: 15.3). Staging included 50 T1a, 21 T1b, and 20 T2 tumors, including three metachronous second primaries. Radiation and/or laryngectomy avoidance was achieved in 87/88 (98.9%) of patients, inclusive of 24 patients requiring KTP re-treatments. Two patients had biopsy-proven recurrence (2.3%), but only 21 of 24 re-treated patients received a formal biopsy. No patients died from laryngeal cancer. DSS and OS were 100% and 92.3%, respectively. The mean VHI-10 scores were 19.3 preoperatively, 3.8 at 6-months postop, and 3.8 at 2-years postop. Smokers had a longer interval to re-treatment (P = .03), patients with T2 lesions had a shorter interval to re-treatment (0.02), and patients with T2 lesions presented with worse initial VHI-10 scores (0.002). CONCLUSIONS: A multi-institutional, retrospective case series of TLM-KTP ablation of EGC demonstrated excellent oncologic outcomes when close surveillance and proactive re-treatments were utilized. Disease-specific survival, overall survival, and vocal function were excellent. Additional studies are necessary to further analyze the merits and risks of this treatment approach.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Glote/cirurgia , Neoplasias Laríngeas/cirurgia , Lasers de Estado Sólido/uso terapêutico , Idoso , Carcinoma de Células Escamosas/patologia , Intervalo Livre de Doença , Feminino , Seguimentos , Glote/patologia , Humanos , Neoplasias Laríngeas/patologia , Masculino , Microcirurgia , Recidiva Local de Neoplasia/cirurgia , Retratamento/estatística & dados numéricos , Estudos Retrospectivos , Qualidade da Voz
2.
J Acoust Soc Am ; 148(6): 3562, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33379897

RESUMO

Wearing face masks (alongside physical distancing) provides some protection against infection from COVID-19. Face masks can also change how people communicate and subsequently affect speech signal quality. This study investigated how three common face mask types (N95, surgical, and cloth) affected acoustic analysis of speech and perceived intelligibility in healthy subjects. Acoustic measures of timing, frequency, perturbation, and power spectral density were measured. Speech intelligibility and word and sentence accuracy were also examined using the Assessment of Intelligibility of Dysarthric Speech. Mask type impacted the power distribution in frequencies above 3 kHz for the N95 mask, and above 5 kHz in surgical and cloth masks. Measures of timing and spectral tilt mainly differed with N95 mask use. Cepstral and harmonics to noise ratios remained unchanged across mask type. No differences were observed across conditions for word or sentence intelligibility measures; however, accuracy of word and sentence translations were affected by all masks. Data presented in this study show that face masks change the speech signal, but some specific acoustic features remain largely unaffected (e.g., measures of voice quality) irrespective of mask type. Outcomes have bearing on how future speech studies are run when personal protective equipment is worn.


Assuntos
/prevenção & controle , Máscaras/efeitos adversos , Acústica da Fala , Inteligibilidade da Fala , Adulto , Feminino , Humanos , Masculino , Qualidade da Voz , Adulto Jovem
3.
Rev Med Suisse ; 16(717): 2348-2350, 2020 Dec 02.
Artigo em Francês | MEDLINE | ID: mdl-33263961

RESUMO

A child having a hoarse, raspy or broken voice, is not normal. Child voice problems are too often ignored and neglected. Such problem should be treated as quickly as possible, as they have important academic and social consequences and significant implications for the choice of their future adult life. The problem must be solved before adolescence, because many professions and activities are not accessible to dysphonic children. Our society gives a lot of importance to the voice, but curiously without having sufficient knowledge of vocal hygiene. Information and awareness among doctors and parents is paramount so that school-aged children can benefit from adequate treatment.


Assuntos
Distúrbios da Voz/terapia , Qualidade da Voz , Criança , Humanos , Distúrbios da Voz/reabilitação
4.
Braz. j. otorhinolaryngol. (Impr.) ; 86(6): 748-762, Nov.-Dec. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1142601

RESUMO

Abstract Introduction: The voice of individuals with hearing impairment has been widely described, and can be compromised in all levels of the phonatory system. Objective: To develop and validate an instrument for evaluating the voice of this population. Methods: The instrument underwent the validation steps suggested by the Scientific Advisory Committee of the Medical Outcomes Trust. The study sample consisted of seventy-eight Brazilian people with cochlear implants (experimental group) and 78 individuals with normal hearing (control group), divided in groups by age range — children from 3 to 5 years; children from 6 to 10 years and adults from 18 to 46 years. The study sample participated in a voice recording of the sustained vowel /a/, connected speech and spontaneous conversation, in which three voice specialists rated using the proposed instrument. It consists of visual-analog scales of suprasegmental aspects, respiratory-phonatory coordination, resonance, phonation, additional parameters and general vocal perception. Results: Evaluation by an expert committee and a pilot test established content validity. Reliability measures showed excellent test-retest reproducibility for the majority of the parameters. Analysis with the ROC curve showed that perceptual evaluation with the sustained vowel did not strongly differentiate individuals with cochlear implants from those with normal hearing, and the parameter "speech rate" did not differentiate the groups at all. For the connected speech and spontaneous conversation, the majority of the parameters differentiated the experimental group from the control group with an area under the curve ≥0.7. The cutoff values with maximum specificity and sensitivity were 30.5 for mild, 49.0 for moderate and 69.5 for intense deviation. Conclusions: The protocol for the evaluation of voice in subjects with hearing impairment, PEV-SHI, is a reliable and useful tool for assessing the particularities of the voice of individuals with hearing impairment treated with cochlear implants and can be used in research and clinical settings to standardize evaluation and facilitate information exchange among services.


Resumo Introdução: A voz de indivíduos com deficiência auditiva tem sido amplamente descrita e pode estar comprometida em todos os níveis do sistema fonatório. Objetivo: Desenvolver e validar uma ferramenta para avaliar a voz dessa população. Método: A ferramenta foi submetida às etapas de validação sugeridas pelo Scientific Advisory Committee of the Medical Outcomes Trust. A amostra do estudo foi composta por 78 indivíduos brasileiros com implantes cocleares (grupo experimental) e 78 indivíduos com audição normal (grupo controle) divididos em grupos por faixa etária - crianças de 3 a 5 anos; crianças de 6 a 10 anos e adultos de 18 a 46 anos. Os participantes do estudo realizaram uma gravação de voz da vogal /a/ sustentada, fala encadeada e conversa espontânea, que foi avaliada por três especialistas em voz com o instrumento proposto. Este instrumento consistem em escalas visuais analógicas dos aspectos suprassegmentares da voz, coordenação pneumofonoarticulatória, ressoância, fonação, parâmetro adicional e impressão geral da qualidade vocal. Resultados: A avaliação por um comitê de especialistas e um teste-piloto estabeleceram a validade de conteúdo. Medidas de confiabilidade mostraram excelente reprodutibilidade teste-reteste para a maioria dos parâmetros. A análise com a curva ROC mostrou que a avaliação perceptivo-auditiva com a vogal sustentada não diferenciou significantemente os indivíduos com implante coclear daqueles com audição normal e o parâmetro "velocidade de fala" não diferenciou os grupos. Para a fala encadeada e conversa espontânea, a maioria dos parâmetros diferenciou o grupo experimental do grupo controle, com uma área sob a curva ≥ 0,7. Os valores de corte com máxima especificidade e sensibilidade foram 30,5 para desvio discreto, 49,0 para desvio moderado e 69,5 para desvio intenso. Conclusões: O protocolo de avaliação de voz do deficiente auditivo é uma ferramenta confiável e útil para avaliar as particularidades da voz de indivíduos com deficiência auditiva e implante coclear e pode ser utilizada em pesquisas e contextos clínicos para padronizar a avaliação e facilitar a troca de informações entre os serviços.


Assuntos
Humanos , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Percepção da Fala , Perda Auditiva/diagnóstico , Acústica da Fala , Medida da Produção da Fala , Qualidade da Voz , Brasil , Reprodutibilidade dos Testes
5.
Braz. j. otorhinolaryngol. (Impr.) ; 86(6): 669-675, Nov.-Dec. 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1142589

RESUMO

Abstract Introduction: Difficulties or limitations in producing high-pitched sounds while singing may be due to the vocal technique used or organic factor. The observation of such difficulty or limitation by singing teachers is one of the main reasons affected individuals are referred to otolaryngologists. Objective: To evaluate the laryngostroboscopic and electromyographic changes in the cricothyroid muscles of singers with difficulties or limitations producing high-pitched sounds. Methods: This is a cross-sectional study. Ten singers with difficulty producing high-pitched sounds underwent voice, laryngostroboscopic, and electromyographic evaluations. Results: None of the evaluated singers presented signs of impairment of the superior laryngeal nerve on laryngostroboscopy. The electromyographic findings for the cricothyroid muscle were normal for all singers. Six singers presented vocal fold lesions, seven had signs suggestive of laryngopharyngeal reflux, and two presented vascular changes. Conclusion: No signs suggestive of superior laryngeal nerve paresis or paralysis were observed on laryngostroboscopy and electromyography of the cricothyroid muscle in singers with difficulties or limitations producing high-pitched sounds. The presence of vocal fold lesions should be investigated in this population.


Resumo Introdução: Dificuldades ou limitações na produção de sons agudos durante o canto podem ser decorrentes da técnica vocal utilizada ou de fatores orgânicos. A observação dessa dificuldade ou limitação pelos professores de canto é uma das principais razões pelas quais os indivíduos afetados são encaminhados aos otorrinolaringologistas. Objetivo: Avaliar as alterações laringoestroboscópicas e eletromiográficas no músculo cricotireóideo de cantores com dificuldades ou limitações na produção de sons agudos. Método: Estudo de coorte transversal. Dez cantores com dificuldade de produzir sons agudos foram submetidos a avaliações de voz, laringoestroboscópicas e eletromiográficas. Resultados: Nenhum dos cantores avaliados apresentou sinais de comprometimento do nervo laríngeo superior na laringoestroboscopia. Os achados eletromiográficos para o músculo cricotireóideo foram normais para todos os cantores. Seis cantores apresentaram lesões nas pregas vocais, sete apresentaram sinais sugestivos de refluxo laringofaríngeo e dois apresentaram alterações vasculares. Conclusão: Não foram observados sinais sugestivos de paresia ou paralisia do nervo laríngeo superior na laringoestroboscopia e eletromiografia do músculo cricotireóideo em cantores com dificuldades ou limitações na produção de sons agudos. A presença de lesões nas pregas vocais deve ser investigada nessa população.


Assuntos
Humanos , Distúrbios da Voz , Canto , Qualidade da Voz , Estudos Transversais , Estroboscopia , Eletromiografia
6.
Bol. méd. postgrado ; 36(2): 48-52, dic.2020. tab, graf
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1117900

RESUMO

Se realizó un estudio retrospectivo de revisión de 95 historias clínicas con el objetivo de determinar los factores predisponentes a la disfonía por hiperfunción laríngea en pacientes adultos que asistieron a la consulta de Otorrinolaringología del Hospital Universitario Dr. Luis Gómez López durante el lapso enero-diciembre 2016 a Junio 2017. Entre los resultados se encontró una predominancia del sexo masculino (82,4%) y una edad entre 37 a 44 años en 96,8% de los casos; 38% de los pacientes son profesionales expuestos a contaminación ambiental, 25% son profesionales de la voz; 79% no refiere tener hábito tabáquico; 38% refirió abusar de la voz, siendo las principales causas el hablar en exceso, cantar y gritar. El 67,4% de los pacientes están expuestos a vapores tóxicos, 86,3% al humo del tabaco y 82,1% al humo de la leña. El grado de disfonía más frecuente diagnosticado por nasofibrolaringoscopía fue grado II (60%). Es importante la detección temprana de los factores predisponentes asociados a la disfonía por hiperfunción laríngea de forma de implementar acciones que favorezcan las condiciones laborales y ambientales y mitiguen su influencia en la fisiología de la voz(AU)


A retrospective review of 95 medical charts was carried out with the objective of determining the predisposing factors for laryngeal hyperfunction dysphonia in adult patients attending the otorhinolaryngology consult of the Hospital Universitario Dr. Luis Gómez López, during the period January-December 2016 to June 2017. The results show a male predominance (82.4%) and an age between 37 to 44 years in 96.8% of cases; 38% of patients are professionals exposed to environmental pollution and 25% are voice professionals; 79% of patients don't smoke; 38% of cases abuse voice by speaking frequently, singing and shouting. 67.4% of patients have been exposed to vapors, 86.3% to tobacco smoke and 82.1% to firewood. Degree of dysphonia diagnosed by nasofibrolaryngoscopy was grade II (60%). Early detection of predisposing factors associated to laryngeal hyperfunction dysphonia is important in order to implement environmental actions to mitigate their influence in voice physiology(AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Qualidade de Vida , Distúrbios da Voz , Doenças da Laringe , Disfonia/diagnóstico , Disfonia/etiologia , Otolaringologia , Estresse Psicológico , Qualidade da Voz
7.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 55(11): 1027-1031, 2020 Nov 07.
Artigo em Chinês | MEDLINE | ID: mdl-33210881

RESUMO

Objective: To investigate the efficacy of type I thyroplasty with Montgomery prosthesis implantation for the treatment of unilateral vocal fold paralysis. Methods: From May 2015 to March 2019, 46 patients (24 males, 22 females, with age range of 23-77) with unilateral vocal fold paralysis underwent thyroplasty with Montgomery prosthesis implantation in the Department of Otorhinolaryngology Head and Neck Surgery in both the First Affiliated Hospital of Navy Medical University and Guangdong Provincial People's Hospital. The assessment methods included GRBAS auditory perception assessment, acoustic analysis such as Jitter, Shimmer, NHR and maximum phonation time (MPT). Results: Postoperative videostroboscopy observed the displacement of paralyzed vocal fold to the midline in 44 cases as well as significantly reduced glottic fissures during phonation. In the other 2 cases, glottic fissure did not reduce significantly. Compared with preoperative data, the scores of all parameters in GRBAS auditory perception assessment were lower except the parameter S, and the acoustic analysis parameters (jitter, shimmer, NHR) were smaller, and MPT was longer. All the difference was statistically significant (P<0.001). Revision surgery was performed in 2 patients with poor results. No serious complications occurred in all the cases. Conclusions: For the patients with unilateral vocal fold paralysis who are not suitable for the laryngeal reinnervation surgery due to old age or long course of denervation, thyroplasty with Montgomery prosthesis implantation can effectively improve the voice of patients with high safety,which is worthy of promotion.


Assuntos
Laringoplastia , Paralisia das Pregas Vocais , Feminino , Humanos , Masculino , Próteses e Implantes , Resultado do Tratamento , Paralisia das Pregas Vocais/cirurgia , Prega Vocal , Qualidade da Voz
8.
Codas ; 32(5): e20180052, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33174981

RESUMO

PURPOSE: To verify the association between laryngopharyngeal reflux (LPR) with age, gender, vocal deviation and voice complaints. METHODS: The study included patients between 18 and 70 years old, referred to the Otorhinolaryngology service for complaints of voice or reflux, of both sexes. Endolaryngeal findings were classified using the Reflux Finding Score (RFS) scale. The presence or absence of vocal and reflux complaints was verified and correlated with the RFS classification. On the same date, they were submitted to sustained vowel voice recording and chained speech. The auditory-perceptual assessment was performed by a speech therapist, classifying the general degree of vocal deviation based on the GRBASI scale. RESULTS: Ninety-seven patients were evaluated, with a mean age of 42. 6 years, 62. 3% female, and mean RFS scores of 6. 26 points. Among the patients, 48 subjects had vocal complaints, 34 women with a mean age of 44. 9 years and an average RFS score of 6. 94 points. The other 49 individuals had no vocal complaints, and of these 27 were women, with a mean age of 41. 2 years and a mean RFS score of 5. 5 points. The variables "reflux complaint", "vocal complaint" and age were the ones that most correlated with the RFS scale scores. CONCLUSION: There is a relationship among reflux complaints, laryngeal findings and vocal complaint.


Assuntos
Refluxo Laringofaríngeo , Voz , Adolescente , Adulto , Idoso , Feminino , Humanos , Refluxo Laringofaríngeo/complicações , Refluxo Laringofaríngeo/diagnóstico , Masculino , Pessoa de Meia-Idade , Qualidade da Voz , Adulto Jovem
9.
Codas ; 32(5): e2019022, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33053081

RESUMO

PURPOSE: Analyze the measures of the fundamental frequency, electroglotographic jitter, contact quotient and periodicity of the electroglotographic waves of the singers in habitual voice. METHOD: A cross-sectional observational study, which selected individuals from singing schools in the central region of the municipality of Belo Horizonte. The sample was non-probabilistic, for convenience consisted of 60 singers aged between 18 and 55 years, 30 males and 30 females. For the electroglotographic record collection, the Kay Pentax ™ CSL program, model 6103, the Electroglotographic module was used. The participants were placed in a seated position, and after cleaning the skin of the neck with 70% alcohol, two electrodes were placed on the wings of the thyroid cartilage at the level of the vocal folds. Subsequently, the participants were instructed to emit the vowel/a/sustained in a habitual way. The measurements of the fundamental frequency (f0), contact quotient (QC), electroglotographic jitter and periodicity of the electroglotographic wave were analyzed. The data were statistically analyzed using Minitab 17. RESULTS: The parameters analyzed were statistically significant. The fundamental frequency (f0) was higher in females (226.91Hz) when compared to males (166.54Hz). The measure of contact quotient and periodicity was also higher in women (40.46% and 15.51% respectively) when compared to men (27.45% and 7.82, respectively). The jitter parameter was higher in men when compared to women. CONCLUSION: Women presented higher values in the fundamental frequency (f0), contact quotient (QC) and periodicity of the wave compared to men. The men presented the jitter value higher than that of the women.


Assuntos
Canto , Voz , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Acústica da Fala , Qualidade da Voz , Adulto Jovem
10.
Codas ; 32(5): e20190079, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33053084

RESUMO

PURPOSE: To investigate the self-perception by individuals on the immediate effects of three semi-occluded vocal tract exercises (SOVTE), that is, phonation into a latex tube, finger kazoo and phonation into a high-resistance straw, and to compare the self-perception results between the high and low voice groups. METHOD: The study participants consisted of 26 choristers (seven sopranos, seven altos, six tenors, and six basses) subdivided into high and low voices with ages ranging from 18 to 58 years. Voice samples of each subject were recorded before and after performing the exercises randomly for three subsequent weeks. A self-assessment questionnaire was applied. RESULTS: All exercises had a statistically significant improvement, according to the participants' self-perception. Latex tube phonation was the preferred technique for 11 (84.62%) participants in the low voice group; while the high-resistance straw was reported as the less beneficial exercise by 10 (79.92%) participants in the same group. On the other hand, the high-resistance straw (9; 69.2%) was the preferred exercise for the high voice group; while finger kazoo (6; 46.15%) and latex tube (5; 38.4%) were the least beneficial exercises. CONCLUSION: The study showed that the effects of these exercises are different and should be suited for each type of voice, such as the latex tube, which was the most preferred by low voice participants and also rated as less beneficial by high voice participants, and the high-resistance straw, which was the most preferred by the high voice participants and also rated as less beneficial by low voice participants.


Assuntos
Qualidade da Voz , Voz , Adolescente , Adulto , Humanos , Pessoa de Meia-Idade , Fonação , Autoimagem , Treinamento da Voz , Adulto Jovem
11.
Clinics (Sao Paulo) ; 75: e1682, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32876106

RESUMO

OBJECTIVES: The objective of the study was to establish a cut-off point for high dysphonia risk in children using the Child Dysphonia Risk Screening Protocol (DRSP-C). METHODS: Through a preliminary study, voice recordings of 59 children (4-12 years of age) were collected during an auditory-perceptual analysis using the Consensus Auditory-Perceptual Evaluation of Voice protocol. Thirty of the patients had voice disorders (patient group), and 29 did not (control group). A risk score for dysphonia was then calculated, and data were compared between groups. The relationship between overall degrees of deviation and questionnaire scores was analysed. The questionnaire's validity was verified from the area under the Receiver Operating Characteristic (ROC) curve, and cut-off points were obtained based on diagnostic criteria for screening procedures. RESULTS: The DRSP-C score was found to be higher for the patient group, as was the partial score for vocal behaviour. No correlation was found between overall degrees of dysphonia and questionnaire scores. The area under the ROC curve was measured as 0.678, denoting limited diagnostic capacity. The cut-off point was set at 16.50. Thus, above this value, dysphonia risk is higher. CONCLUSION: A cut-off point for high dysphonia risk was calculated. The DRSP-C proved to be a promising tool for children's clinical vocal and health promotion and should be used in conjunction with General Dysphonia Risk Screening.


Assuntos
Disfonia , Criança , Pré-Escolar , Disfonia/diagnóstico , Humanos , Curva ROC , Índice de Gravidade de Doença , Inquéritos e Questionários , Qualidade da Voz
12.
PLoS One ; 15(9): e0238451, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32881917

RESUMO

Organizational effectiveness is contingent upon employees' contributions; however, the role of employee voice behavior as a critical component of employees' contribution to the organization has not been sufficiently acknowledged. Based on proactive behavior theory, we present a model to investigate employee voice behavior as an underlying mechanism in the relationship between supervisor delegation and perceived workplace inclusion. Using the SEM (structural equation modeling) method, we test our model's hypotheses with data from 271 employee-supervisor questionnaires administered in state-owned enterprises in the telecommunications industry. The results show that supervisor delegation is positively related to employees' promotive and prohibitive voice behavior. Promotive voice significantly influences perceived workplace inclusion, but prohibitive voice behavior was not found to have any impact on perceived workplace inclusion. Moreover, both dimensions of voice behavior, i.e., promotive and prohibitive voice behavior, significantly mediate the relationship between supervisor delegation and perceived workplace inclusion.


Assuntos
Emprego/organização & administração , Telecomunicações/tendências , Qualidade da Voz/fisiologia , Adulto , Idoso , Feminino , Humanos , Indústrias , Masculino , Pessoa de Meia-Idade , Cultura Organizacional , Organizações , Fonação/fisiologia , Comportamento Social , Inquéritos e Questionários , Voz/fisiologia , Local de Trabalho/organização & administração
13.
Codas ; 32(4): e20190135, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32813819

RESUMO

PURPOSE: To evaluate the ability that in tune and out of tune individuals have to identify normal and deviated voice qualities and to compare it with their performance in auditory processing tests and perceptual judgment. METHOD: The study investigated 15 in tune and 15 out of tune individuals. Participants were matched for age and sex, were amateur choir singers, had normal hearing thresholds and normal vocal quality. All individuals underwent Pitch-matching scanning to be classified as in or out of tune. Next, they performed the Pitch Pattern Sequence (PPS) and the Duration Pattern Sequence (DPS) tests and the perceptual judgment of 36 voices plus 20% of repetition for reliability analysis. RESULTS: The out of tune individuals had worse performance in the PPS and DPS for both ears (p=0.002 RE; p=0.001 LE; p=0.009 DPS); no difference was observed in the perceptual judgment and the reliability (p=0.153). However, participants with normal PPS and DPS had better performance in the perceptual judgment and better reliability (p=0.033). Thus, individuals with disorders in temporal auditory processing skills have greater difficulty in the perceptual judgment and have lower intra-rater reliability, despite being in or out of tune. CONCLUSION: It can be observed that voice tone is not required to guarantee good perceptual judgment. However, temporal patterns and intra-rater reliability are essential to perceptually assess normal and altered voice qualities. Therefore, auditory training should be included in programs that aim to develop voice perceptual judgment abilities.


Assuntos
Transtornos da Percepção Auditiva/fisiopatologia , Transtornos da Percepção Auditiva/psicologia , Julgamento , Acústica da Fala , Qualidade da Voz , Percepção Auditiva , Estudos de Casos e Controles , Audição , Testes Auditivos , Humanos , Reprodutibilidade dos Testes
14.
Braz. j. otorhinolaryngol. (Impr.) ; 86(4): 497-501, July-Aug. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1132611

RESUMO

Abstract Introduction There are no official diagnostic protocols for singing voice assessment. In this publication, on the basis of a literature review, standards for the singing voice handicap index exclusively dedicated to voice disorders in singing have been given. Objective The study aims to determine the normative values for the singing voice handicap index. Methods The study is a systematic review and a meta-analysis. A systematic literature search was performed using PubMed to access relevant databases and to locate outcome studies. The "inclusion" criteria were as follows: English language, original papers and human studies retrospective and prospective papers, cross-sectional and case-control studies. Results Eight articles were included for the final analysis. The normative value for the singing voice handicap index was 20.35 with a confidential range of 10.6-30.1 for a group of 729 healthy subjects whose voices were judged as normal, with an age range of 16-64 years. Conclusion The mean normative value of the singing voice handicap index was 20.35 with the confidence levels between 10.6 and 30.1.


Resumo Introdução Não há protocolos diagnósticos oficiais para avaliação de voz no canto. Neste estudo baseado em uma revisão de literatura, são fornecidos padrões para o índice de desvantagem vocal no canto exclusivamente dedicado a distúrbios vocais no canto. Objetivo Determinar os valores normativos para o índice de desvantagem vocal no canto. Método O estudo é uma revisão sistemática com metanálise. Uma busca sistemática da literatura foi feito no PubMed para acessar bancos de dados relevantes e para localizar estudos de desfecho. Os critérios de inclusão foram: estudos escritos em inglês, artigos originais e estudos em seres humanos, retrospectivos e prospectivos, estudos transversais e de caso-controle. Resultados Oito artigos foram incluídos na análise final. O valor normativo para o índice de desvantagem vocal no canto foi de 20,35 com intervalo de confiança de 10,6 a 30,1 em um grupo de 729 indivíduos saudáveis cujas vozes foram consideradas normais, de 16 a 64 anos. Conclusões O valor normativo médio do índice de desvantagem vocal no canto foi de 20,35 com intervalo de confiança entre 10,6 e 30,1.


Assuntos
Humanos , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Voz , Distúrbios da Voz , Canto , Qualidade da Voz , Estudos Transversais , Estudos Prospectivos , Estudos Retrospectivos
15.
J Appl Oral Sci ; 28: e20200052, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32813841

RESUMO

The pursuit for quality of life urged a better understanding of aspects involved in ageing to minimize its consequences. Although many studies investigated older adults' voice, aspects affecting this population voice-related quality of life have not yet been explored. Objective To investigate how aerodynamics and vocal aspects are associated with voice-related quality of life in older adults. Methodology fifty-six older adults aged 60 years or above - 39 women and 17 men - were evaluated. The following procedures were performed: application of the Voice-Related Quality of Life (V-RQOL) protocol; vocal assessment, including auditory-perceptual and acoustic analysis, from which we obtained fundamental frequency (F 0 ), standard deviation of fundamental frequency (SDF 0 ), shimmer, amplitude perturbation quotient (APQ), jitter, pitch period perturbation quotient (PPQ), and harmonics to noise ratio (HNR); aerodynamic assessment using a spirometer; and maximum phonation time (MPT) for /a/, /s/, /z/ and number counting. Results older adults tend to present high V-RQOL scores. Among women, roughness, APQ, and HNR parameters were negatively correlated with V-RQOL, whereas F 0 was positively. We found no correlation between spirometry measurements and V-RQOL. MPT for /a/, /z/, and number counting was positively correlated with V-RQOL solely among men. Conclusion Vocal roughness and acoustic parameters have a negative impact on the quality of life of older women. Respiratory aspects related to the available air support for speaking affected the most the voice-related quality of life of older men.


Assuntos
Acústica da Fala , Qualidade da Voz , Acústica , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida
16.
Codas ; 32(3): e20180304, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32638826

RESUMO

PURPOSE: Verify the perception of popular and classical singers in relation to vocal symptoms and their possible relations regarding knowledge of health and vocal hygiene. METHOD: This study was composed of 242 singers, aged between 17 and 60, of both sexes. A total of 56 singers were selected, with 186 singers, divided into 104 Popular Singers Group (PSG) and 82 Classical Singers Group (CSG). All participants answered the questionnaire for identification and also vocal self-assessment, and two protocols were applied, namely: Brazilian validated version of Voice Symptom Scale - VoiSS (Escala de Sintomas Vocais - ESV) and Questionário de Saúde e Higiene Vocal (QSHV). RESULTS: The largest number of participants was female. The classical singers presented more time of singing class than the popular ones. Show hours of 1-2 hours was higher in the number of subjects responding to both groups of singers. Classical singers presented greater perception of vocal symptoms when compared to the popular ones for total and emotional scores of the Brazilian validated version of VoiSS. The popular and classical groups do not make any difference regarding health and vocal hygiene, even though the groups obtained values above the QSHV normality score. There was no correlation between knowledge about vocal health and hygiene and vocal symptoms in singers. CONCLUSION: Classical singers are more affected by vocal changes, especially women. The singers obtained a good degree of knowledge in vocal hygiene, not differing about the styles. The perception of vocal alteration in popular and classical singers seems to have no relation with the degree of health knowledge and vocal hygiene.


Assuntos
Higiene , Autoimagem , Canto , Distúrbios da Voz , Adolescente , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Qualidade da Voz , Adulto Jovem
17.
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
18.
Sci Rep ; 10(1): 10517, 2020 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-32601277

RESUMO

In voice research and clinical assessment, many objective parameters are in use. However, there is no commonly used set of parameters that reflect certain voice disorders, such as functional dysphonia (FD); i.e. disorders with no visible anatomical changes. Hence, 358 high-speed videoendoscopy (HSV) recordings (159 normal females (NF), 101 FD females (FDF), 66 normal males (NM), 32 FD males (FDM)) were analyzed. We investigated 91 quantitative HSV parameters towards their significance. First, 25 highly correlated parameters were discarded. Second, further 54 parameters were discarded by using a LogitBoost decision stumps approach. This yielded a subset of 12 parameters sufficient to reflect functional dysphonia. These parameters separated groups NF vs. FDF and NM vs. FDM with fair accuracy of 0.745 or 0.768, respectively. Parameters solely computed from the changing glottal area waveform (1D-function called GAW) between the vocal folds were less important than parameters describing the oscillation characteristics along the vocal folds (2D-function called Phonovibrogram). Regularity of GAW phases and peak shape, harmonic structure and Phonovibrogram-based vocal fold open and closing angles were mainly important. This study showed the high degree of redundancy of HSV-voice-parameters but also affirms the need of multidimensional based assessment of clinical data.


Assuntos
Endoscopia , Aprendizado de Máquina , Distúrbios da Voz/diagnóstico , Qualidade da Voz/fisiologia , Fatores Etários , Feminino , Humanos , Laringoscopia , Masculino , Distúrbios da Voz/fisiopatologia
19.
Adv Clin Exp Med ; 29(7): 865-871, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620054

RESUMO

BACKGROUND: Short and long-term results of microsurgical treatment with the mini-microflap technique in patients with Reinke's edema (RE) were assessed based on the phonatory and ventilatory functions of the larynx. OBJECTIVES: To assess the short and long-term results of microsurgical treatment with the mini-microflap technique in patients with RE based on the phonatory and ventilatory functions of the larynx. MATERIAL AND METHODS: Twenty patients diagnosed with advanced stage of RE confirmed with laryngovideostroboscopy (LVS) were enrolled in the study. Phonatory function disturbances were additionally assessed on the basis of Maximum Phonation Time (MPT) measurement, Voice Handicap Index (VHI) and Voice-Related Quality of Life (V-ROOL) questionnaires. Ventilatory function was assessed using spirometry. The aforementioned complex examinations were conducted prior to surgery and 1, 6 and 9 months following the surgery. RESULTS: Good postsurgical results were obtained in subjective and objective evaluation, which assessed the phonatory function and ventilatory parameters. Post-surgery increase in MPT, VHI and VQROL was noticed in all patients in 3 check points (p < 0.001). The results demonstrate postsurgical improvement for some LVS parameters, including assessment of glottis closure (p < 0.003) observed 6 months after the surgery. An improvement in most of the ventilation parameters was observed also 6 months after surgery (p < 0.001). For the spirometry flow parameter PEF, significant improvement was noted in each check point (p1 < 0.004, p6 < 0.001, p9 < 0.001). The study revealed a correlation between phonatory parameter - MPT and PEF observed 1 month after the procedure (p = 0.026), confirming the interdependence of ventilatory efficiency and phonatory condition of larynx. CONCLUSIONS: Mini-microflap surgery brings satisfactory clinical effect in patients with advanced stages of RE by optimization of phonatory and ventilatory functions of the larynx.


Assuntos
Microcirurgia , Qualidade de Vida , Edema/cirurgia , Humanos , Fonação , Resultado do Tratamento , Prega Vocal , Qualidade da Voz
20.
Artigo em Inglês | MEDLINE | ID: mdl-32604875

RESUMO

(1) Introduction: Laryngeal cancer is one of the most common types of cancer affecting the upper aerodigestive tract. Despite ensuring good oncological outcome in many locoregionally advanced cases, total laryngectomy is associated with relevant physical and psychological sequelae. Treatment through tracheo-esophageal speech, if promising, can lead to very variable outcomes. Not all laryngectomee patients with vocal prosthesis benefit from the same level of rehabilitation mainly due to the development of prosthetic or fistula related problems. The relating sequelae in some cases are even more decisive in the patient quality of life, having a higher impact than communicational or verbal skills. (2) Material and Methods: A retrospective study was conducted on 63 patients initially enrolled with a history of total laryngectomy and voice rehabilitation, treated at the University Hospital of Catania from 1 January 2010 to 31 December 2018. Quality of life (QoL) evaluation through validated self-administrated questionnaires was performed. (3) Results: The Voice-Related Quality of Life questionnaire revealed significantly better outcomes in both socio-emotional and functional domains of the tracheoesophageal patient group compared to the esophageal group (p = 0.01; p = 0.01, respectively), whereas in the Voice Handicap Index assessment, statistically significant scores were not achieved (p = 0.33). (4) Discussion: The significant differences reported through the V-RQOL and Voice Handicap Index scales in the presence of fistula related problems and device lifetime reduction when compared to the oesophageal speech group have demonstrated, as supported by the literature, a crucial role in the rehabilitative prognosis. (5) Conclusions: The criteria of low resistance to airflow, optimal tracheoesophageal retention, prolonged device life, simple patient maintenance, and comfortable outpatient surgery are the reference standard for obtaining good QoL results, especially over time. Furthermore, the correct phenotyping of the patient based on the main outcomes achieved at clinical follow-up guarantees the primary objective of the identification of a better quality of life.


Assuntos
Laringe Artificial , Fístula Traqueoesofágica , Idoso , Feminino , Humanos , Neoplasias Laríngeas/cirurgia , Laringectomia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estudos Retrospectivos , Fístula Traqueoesofágica/cirurgia , Qualidade da Voz
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