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2.
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
3.
Ann Otol Rhinol Laryngol ; 129(10): 1030-1039, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32449369

RESUMO

OBJECTIVE: Laryngopharyngeal reflux (LPR) and associated symptoms can be refractory to treatment with acid suppressing medication. We investigated the role and evidence for complementary and alternative medicine (CAM) for LPR in this systematic review. REVIEW METHODS: Complementary and alternative treatment was defined in this systematic review as any non-acid suppressing medication, treatment, or therapy. A literature search was performed by two authors in consultation with a medical librarian using controlled vocabulary for "complementary and alternative medicine" and "laryngopharyngeal reflux" in the databases PubMed and EMBASE, with supplemental searches with Google Scholar. RESULTS: Twenty articles were included in this review for the modalities: alginate, diet modification, prokinetics, respiratory retraining, voice therapy, rikkunshito (RKT), hypnotherapy, and sleep positioning. The studies were analyzed for bias based on the Cochrane criteria for RCTs and Methodological Index for non-RCT (MINORS) criteria for all other studies. For each modality a level of evidence was assigned to the current body of evidence using the GRADE approach. CONCLUSION: There is mixed evidence with a high degree of bias and heterogeneity between studies for the modalities presented in the paper. Based on this review, an anti-reflux diet is recommended for all patients and there is some low-quality evidence to support alkaline water. For patients with predominant vocal symptoms there is evidence that supports voice therapy. There is insufficient evidence to recommend prokinetics at this time. For patients with predominant globus symptoms, alginate, RKT, and relaxation strategies may be used in conjunction with acid suppressing medications for symptom relief.


Assuntos
Alginatos/uso terapêutico , Exercícios Respiratórios , Terapias Complementares , Dietoterapia , Medicamentos de Ervas Chinesas/uso terapêutico , Hipnose , Refluxo Laringofaríngeo/terapia , Treinamento da Voz , Viés , Humanos , Postura , Sono
4.
Codas ; 32(4): e20190074, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32049106

RESUMO

PURPOSE: To verify and compare the immediate effects of the voiced oral high-frequency oscillation (VOHFO) technique and the phonation into a silicone resonance tube in the elderly self-perception of vocal and laryngeal symptoms and in their voice quality. METHODS: 14 elderly women, over 60 years old, performed the VOHFO and phonation into a resonance tube technique (35cm in length and 9mm in diameter) with one-week interval between both to avoid carry-over effect. Initially, all participants answered questions regarding the frequency and intensity of their vocal/laryngeal symptoms. Recordings of the sustained vowel /a/ and counting numbers were performed for posterior perceptual and acoustic analyses of the voice quality. The maximum phonation time (MPT) for /a/, /s/, /z/ and counting numbers were also obtained. After that, a draw lot established which technique (VOHFO or resonance tube) would be initially applied for three minutes. After the exercise performance the same procedures were carried out and the elderly women answered a self-assessment questionnaire about the effect of the techniques in her voice, larynx, breathing and articulation. Comparison pre and post each technique were analyzed using ANOVA, Wilcoxon and Mann-Whitney tests. The sensations after the techniques were assessed using the Chi-square test (p<0.05). RESULTS: The comparison of both techniques showed decrease in roughness and improvement in resonance for counting numbers after the resonance tube and same outcomes post VOHFO. There were no significant differences for the other analyzed variables between groups. CONCLUSION: The phonation into a resonance tube exercise improves the vocal quality of elderly women. In addition, both exercises are similar regarding self-perception of vocal / laryngeal symptoms and sensations post three minutes of the technique, suggesting that VOHFO can be safely applied in voice therapy for this population.


Assuntos
Laringe/fisiopatologia , Fonação/fisiologia , Acústica da Fala , Qualidade da Voz/fisiologia , Treinamento da Voz , Idoso , Envelhecimento/fisiologia , Feminino , Ventilação de Alta Frequência/métodos , Humanos , Julgamento , Doenças da Laringe/complicações , Pessoa de Meia-Idade , Autoimagem , Autorrelato , Patologia da Fala e Linguagem/métodos , Distúrbios da Voz/fisiopatologia , Distúrbios da Voz/psicologia
5.
J Laryngol Otol ; 134(1): 68-73, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31918788

RESUMO

OBJECTIVE: To determine whether patients would have equivalent or improved outcomes when receiving non-surgical management versus surgical removal for vocal process granulomas. METHODS: A chart review was performed for 53 adults with vocal process granulomas. All patients received baseline anti-reflux treatment consisting of twice-daily proton pump inhibitors and vocal hygiene education. Further treatment approaches were divided into non-surgical (i.e. inhaled corticosteroids, voice therapy, botulinum toxin injections) and surgical groups. Subjective parameters (Voice Handicap Index 10 and Reflux Symptom Index) and outcomes were tabulated and statistically compared. Cause of granuloma was also analysed to determine if this influenced outcomes. RESULTS: Of 53 patients, 47 (89 per cent) experienced reduction in granuloma size, while 37 (70 per cent) experienced complete resolution. The rate of complete granuloma resolution after initial treatment strategy alone was significantly higher in non-surgical compared to surgical patients (67 and 30 per cent, respectively; p = 0.039). No difference in outcome was seen between iatrogenic and idiopathic granulomas. CONCLUSION: Non-surgical patients were more likely to experience initial treatment success than those who underwent surgical removal. Continued emphasis should be placed on conservative treatment options prior to surgery for patients with this condition.


Assuntos
Granuloma/terapia , Laringite/terapia , Inibidores da Bomba de Prótons/uso terapêutico , Prega Vocal/fisiopatologia , Adulto , Idoso , Terapia Combinada , Gerenciamento Clínico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos , Inibidores da Bomba de Prótons/farmacologia , Resultado do Tratamento , Prega Vocal/efeitos dos fármacos , Qualidade da Voz/efeitos dos fármacos , Treinamento da Voz
6.
Auris Nasus Larynx ; 47(1): 7-17, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31587820

RESUMO

OBJECTIVE: To develop a summary of the first version of the Clinical Practice Guideline of Voice Disorders for Diagnosis, Management, and Treatment in Japan by the Clinical Practice Guideline Committee of the Japan Society of Logopedics and Phoniatrics and The Japan Laryngological Association. The 2018 recommendations, based on a review of the scientific literature, are intended to serve as clinical practice guidelines for the diagnosis, management, and treatment of voice disorders in Japan. METHODS: A summary of the original version of the Clinical Practice Guideline of Voice Disorders for Diagnosis, Management, and Treatment in Japan was described. Recommendations for the diagnosis, management, and treatment of voice disorders were prepared. Twelve clinical questions (CQs) regarding the diagnosis, management, treatment, and effectiveness of therapy for voice disorders were also prepared. RESULTS: A summary of the first version of the clinical practice guidelines for the diagnosis, management, and therapy of voice disorders was prepared and is presented. Additionally, answers to the 12 CQs on the diagnosis, management, treatment, and effectiveness of voice disorder therapy were prepared, and include evidence-based recommendations. CONCLUSION: These guidelines present a summary of the standard approaches for the diagnosis and treatment of voice disorders and relevant CQs that consider the medical environments in Japan. We hope that the guidelines will assist physicians in clinical settings for patients with voice disorders.


Assuntos
Guias de Prática Clínica como Assunto , Distúrbios da Voz/diagnóstico , Distúrbios da Voz/terapia , Inibidores da Liberação da Acetilcolina/uso terapêutico , Corticosteroides/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Toxinas Botulínicas/uso terapêutico , Eletromiografia , Humanos , Japão , Músculos Laríngeos/fisiopatologia , Laringoscopia , Microcirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos , Medidas de Resultados Relatados pelo Paciente , Inibidores da Bomba de Prótons/uso terapêutico , Estroboscopia , Distúrbios da Voz/fisiopatologia , Treinamento da Voz
7.
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
8.
J Voice ; 34(1): 156.e15-156.e18, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30041932

RESUMO

OBJECTIVE: Studies have highlighted the importance of having an adequate vocal warm-up exercise regime for prevention of vocal fold injury among singers. Indian classical singing has several singing exercises aimed at improving vocal range and voice. Thus, a need was felt to survey these singers for the warm-up practices they follow and their perception about them. STUDY DESIGN: Cross-sectional study design. METHODS: A 20-item questionnaire was used comprising of questions on demographic details, vocal warm-up singing, and nonsinging-based practices, perceptions about importance of vocal warm-up, and perceptions about effects of vocal warm-up on voice. RESULTS AND CONCLUSION: Fifty Indian classical singers were surveyed. Sixty-four percent of them used vocal warm-up on a daily basis, whereas the remaining did it weekly. Among the singing-based vocal warm-ups, a combination of different singing notes and scales were most commonly used. The popular nonsinging-based warm-up exercises were breathing practice, humming, and meditation. Overall, the singers had a positive perception of the importance of vocal warm-up. Notably, 94% agreed to the importance of having a vocal warm-up regularly before singing. The findings of the present study will help in understanding the existing vocal warm-up regime and perception of the singers. It will benefit counseling singers regarding vocal hygiene, voice care, and management.


Assuntos
Exercícios Respiratórios , Conhecimentos, Atitudes e Prática em Saúde , Meditação , Canto , Distúrbios da Voz/prevenção & controle , Treinamento da Voz , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Fatores de Risco , Distúrbios da Voz/etiologia , Distúrbios da Voz/fisiopatologia , Distúrbios da Voz/psicologia , Adulto Jovem
9.
J Voice ; 34(1): 78-87, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30055980

RESUMO

OBJECTIVE: This study explored trans women's experience and awareness of their vocal communication and voice use within sporting environments. STUDY DESIGN: Mixed methods study. METHODS: Twenty trans women were interviewed about their voice use and vocal communication during sport and its impact on their level of participation. The participants also completed the Transsexual Voice Questionnaire for Male-to-Female Transsexuals. RESULTS: Three core themes emerged from analysis of the interview data. These were: importance of voice in a sport setting, voice production in sporting environments, and psychosocial moderators of voice within the sporting environment. Trans women perceived their voices to be the main barrier to their participation in sport. These women reported that the strong gendered environment of sport made them anxious that they would not be identified as women because their voice was not always congruent with their physical appearance. However, maintaining feminine voice was deemed less critical if participants felt comfortable at their sporting club and had strong relationships with their teammates and coaches. Findings from the Transsexual Voice Questionnaire for Male-to-Female Transsexuals supported the interview data as to the impact that voice has in the lives of trans women. CONCLUSION: Voice is critical for trans women who wish to integrate and be accepted as women in sporting environments. Participants suggested that voice training should target achieving a gender congruent voice and include minimalizing perceived barriers such as vocal fatigue and maintaining adequate breath support.


Assuntos
Atletas/psicologia , Feminização , Acústica da Fala , Pessoas Transgênero/psicologia , Transexualidade/psicologia , Qualidade da Voz , Adolescente , Adulto , Idoso , Feminino , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Opinião Pública , Autoavaliação , Fatores Sexuais , Comportamento Social , Transexualidade/fisiopatologia , Transexualidade/terapia , Treinamento da Voz , Adulto Jovem
10.
J Voice ; 34(1): 88-99, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30072204

RESUMO

INTRODUCTION: Professional activities of university lecturers involve continued and sustained use of the voice, leading in many cases to increased risk of developing voice disorders. Risk identification followed by the fast application of preventive or corrective measures is a key issue in this context. OBJECTIVE: Define and implement a preventive program for the vocal health of university lecturers by using acoustic features automatically extracted from voice recordings to identify risk groups and manage preventive or corrective actions MATERIAL AND METHODS: A total of 170 subjects, aged between 18 and 65, were recruited at the San Pedro de Alcántara Hospital and at the University of Extremadura in Cáceres (Spain). They formed three groups-one of 25 people suffering from vocal fold nodules, another of 25 healthy people, and the third of 120 university lecturers. Medical history and voice status assessment was performed, and voice recordings were made following a research protocol. A feature extraction, selection, and classification procedure was applied to the voice recordings to provide the best predictors for discriminating between pathological and healthy voices. The model parameters were then used to determine the lecturers' probability of suffering vocal fold nodules or other pathologies with similar dysphonic speech. These probabilities were used to classify the lecturers into three risk groups-low, medium, and high. These groups were taken as the basis to assign the lecturers to a primary, secondary, or tertiary prevention level. Different preventive or corrective actions were applied for each prevention level. RESULTS: The best set of predictors comprised sample entropy, correlation dimension, pitch period entropy, glottal noise excitation, and sex, achieving an overall accuracy of 92% with a random forest classifier. They all showed statistically significant differences between vocal fold nodules and healthy groups (P < 0.05). Three out of the four best acoustic features were nonlinear, showing the importance of nonlinear dynamics for clinical practice. The model parameters were applied to the predictors of the lecturers so as to assign them to the different risk groups, leading to 60.8% (73 out of 120) of the lecturers in the low-risk group, 29.2% (35 out of 120) in the medium-risk group, and 10% (12 out of 120) in the high-risk group. The prevention levels were assigned on the basis of this classification and the medical history and laryngological evaluation of some specific subjects. A statistically significant association was found between the voice status and the assigned prevention level (P < 0.001), with there being a clear dependence relationship (Cramér's V = 0.630). CONCLUSION: It is feasible to develop and apply a preventive voice program for university lecturers that is aided by features automatically extracted from voice recordings. As the program progresses, it is expected that the information automatically provided for the assignment to prevention levels will become ever more precise. The method proposed can be extended to other voice professionals and other voice disorders.


Assuntos
Acústica , Docentes , Doenças da Laringe/prevenção & controle , Doenças Profissionais/prevenção & controle , Prevenção Primária , Medida da Produção da Fala , Fala , Distúrbios da Voz/prevenção & controle , Qualidade da Voz , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Doenças da Laringe/diagnóstico , Doenças da Laringe/etiologia , Doenças da Laringe/fisiopatologia , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico , Doenças Profissionais/etiologia , Doenças Profissionais/fisiopatologia , Saúde do Trabalhador , Reconhecimento Automatizado de Padrão , Avaliação de Programas e Projetos de Saúde , Medição de Risco , Fatores de Risco , Comportamento de Redução do Risco , Processamento de Sinais Assistido por Computador , Espectrografia do Som , Espanha , Distúrbios da Voz/diagnóstico , Distúrbios da Voz/etiologia , Distúrbios da Voz/fisiopatologia , Treinamento da Voz , Adulto Jovem
11.
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
12.
J Voice ; 34(1): 160.e1-160.e6, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31825789

RESUMO

BACKGROUND: Voice teachers are seeking increasing amounts of pedagogical instructions in the form of observerships, coursework, and clinical experiences. Yet to date there has been no formalized attempt to categorize or set guidelines for these educational experiences. OBJECTIVES: The aim of this study was to investigate (a) the number of hours of observations required or electively completed during pedagogical training (voice lessons, masterclasses) and clinical observations; (b) the number of hours of mentorship (critical observation of a student by a mentor) during pedagogical training; and (c) differences in the training backgrounds of voice teachers based on the level of training, position, and genre. METHODS: We distributed a survey to 700 voice teachers (102 respondents) of various levels from private to university and across age range of students. The surveys contained questions about the role of observation in the teacher's training. We ran descriptive analysis and examined whether the proportion of participants with ≥10 observation and mentorship hours was different for classical versus the other musical genres. RESULTS: The number of respondents actively observing and being observed during their training was low. Most observations occurred within the classical and musical theater singing styles. Mentored critical observations of students were lower across genres than student observations, with the majority of respondents (67-92%) reporting no hours in genres other than classical. For all genres except classical, there was a larger percentage of respondents who reported teaching the genre than who reported receiving pedagogical training in the genre. Reported clinical voice observation hours were low (28.4% with ≥10 hours), and few respondents had >0 hours of operating room observation experience (11.8%). CONCLUSIONS: There is wide disparity across genres in the number of hours of observation and critical mentoring, and voice teachers' genre of instruction does not frequently match with the genre of pedagogical instruction they have received. More research is needed to determine the significance of this mismatch and whether increased hours of observation and mentoring would benefit voice instruction.


Assuntos
Docentes , Mentores , Canto , Ensino , Qualidade da Voz , Treinamento da Voz , Fatores Etários , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
13.
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
14.
J Voice ; 34(1): 53-67, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30174221

RESUMO

Differences in formant frequencies between men and women contribute to the perception of voices as masculine or feminine. This study investigated whether visual-acoustic biofeedback can be used to help transgender women achieve formant targets typical of cisgender women, and whether such a shift influences the perceived femininity of speech. Transgender women and a comparison group of cisgender males were trained to produce vowels in a word context while also attempting to make a visual representation of their second formant (F2) line up with a target that was shifted up relative to their baseline F2 (feminized target) or an unshifted or shifted-down target (control conditions). Despite the short-term nature of the training, both groups showed significant differences in F2 frequency in shifted-up, shifted-down, and unshifted conditions. Gender typicality ratings from blinded listeners indicated that higher F2 values were associated with an increase in the perceived femininity of speech. Consistent with previous literature, we found that fundamental frequency and F2 make a joint contribution to the perception of gender. The results suggest that biofeedback might be a useful tool in voice modification therapy for transgender women; however, larger studies and information about generalization will be essential before strong conclusions can be drawn.


Assuntos
Biorretroalimentação Psicológica , Feminização , Feedback Formativo , Acústica da Fala , Percepção da Fala , Pessoas Transgênero/psicologia , Transexualidade/terapia , Qualidade da Voz , Treinamento da Voz , Adulto , Idoso , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudo de Prova de Conceito , Fatores Sexuais , Medida da Produção da Fala , Transexualidade/fisiopatologia , Transexualidade/psicologia , Percepção Visual , Adulto Jovem
15.
Laryngoscope ; 130(7): 1750-1755, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31498467

RESUMO

OBJECTIVES/HYPOTHESIS: Voice rest is often prescribed following phonosurgery by most surgeons despite limited empiric evidence to support its practice. This study assessed the effect of postphonosurgery voice rest on vocal outcomes. STUDY DESIGN: Prospective, randomized controlled trial. METHODS: Patients with unilateral vocal fold lesions undergoing CO2 laser excision were recruited in a prospective manner and randomized into one of two groups: 1) an experimental arm consisting of 7 days of absolute voice rest, or 2) a control arm consisting of no voice rest. The primary outcome measure was the Voice Handicap Index-10 (VHI-10) questionnaire. Secondary outcomes included aerodynamic measurements (maximum phonation time), acoustic measures (fundamental frequency, jitter, shimmer, and harmonic-to-noise ratio), and auditory-perceptual measures. Primary and secondary outcomes were assessed preoperatively and reassessed postoperatively at the 1- and 3-month follow-up. Patient compliance to voice rest instructions were controlled for using subjective and objective parameters. RESULTS: Thirty patients were enrolled with 15 randomized to each arm of the study. Statistical analysis for the entire cohort showed a significant improvement in the mean preoperative VHI-10 compared to postoperative assessments at 1-month (19.0 vs. 7.3, P < .05) and 3-month (19.0 vs. 6.2, P < .05) follow-up. However, between-group comparisons showed no significant difference in postoperative VHI-10 at either time point. Similarly, secondary outcome measures yielded no significant difference in between-group comparisons. CONCLUSIONS: Our study shows no significant benefit to voice rest on postoperative voice outcomes as determined by patient self-perception, acoustic variables, and auditory-perceptual analysis. LEVEL OF EVIDENCE: 1b CLINICAL TRIAL NUMBER: NCT02788435 (clinicaltrials.gov) Laryngoscope, 130:1750-1755, 2020.


Assuntos
Doenças da Laringe/cirurgia , Terapia a Laser/métodos , Lasers de Gás/uso terapêutico , Prega Vocal/cirurgia , Qualidade da Voz/fisiologia , Treinamento da Voz , Avaliação da Deficiência , Feminino , Seguimentos , Humanos , Doenças da Laringe/fisiopatologia , Doenças da Laringe/reabilitação , Masculino , Pessoa de Meia-Idade , Fonação/fisiologia , Estudos Prospectivos , Inquéritos e Questionários , Resultado do Tratamento , Prega Vocal/fisiopatologia
16.
Laryngoscope ; 130(4): E183-E189, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31237699

RESUMO

OBJECTIVES/HYPOTHESIS: Odynophonia is generally regarded as a symptom of a voice disorder. However, a subset of patients with odynophonia have debilitating pain out of proportion to the relatively mild degree of dysphonia and are not responsive to voice therapy. The goals of this study were to 1) describe the symptomatology of this subset of patients and differentiate it from typical odynophonia, 2) propose alternate models to explain this phenomenon of primary odynophonia, and 3) present a new treatment paradigm based on the proposed models. STUDY DESIGN: Case series. METHODS: Inclusion criteria were complaint of persistent pain associated with voicing, normal vocal fold mobility, complete glottic closure, and limited or lack of response of pain to voice therapy. Presenting symptoms, voice evaluation, and treatment outcomes were reviewed. RESULTS: Eleven patients fit the inclusion criteria. The degree of pain did not follow the trajectory of vocal improvement with therapy. The pain was stagnant or worsened with voice exercises. The most dramatic improvement came about in one patient who received false vocal fold Botox injections, and another who received thyrohyoid lidocaine/triamcinolone injection. We propose that these patients had developed primary odynophonia, in which the pain had become self-sustaining and no longer responded to correction of hyperfunctional vocal behavior. The mechanism of pain persistence may involve superior laryngeal neuralgia, cartilaginous or ligamentous inflammation, and/or central sensitization. CONCLUSIONS: A minority of patients have primary odynophonia distinct from typical odynophonia. Direct treatment of pain may be advisable prior to or in conjunction with voice therapy. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:E183-E189, 2020.


Assuntos
Manejo da Dor/métodos , Dor/fisiopatologia , Distúrbios da Voz/fisiopatologia , Distúrbios da Voz/terapia , Adolescente , Adulto , Idoso , Disfonia/fisiopatologia , Disfonia/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Retrospectivos , Índice de Gravidade de Doença , Qualidade da Voz , Treinamento da Voz
17.
J Telemed Telecare ; 26(6): 365-375, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30823854

RESUMO

People with quadriplegia have a high risk for respiratory illness, social isolation and depression. Previous research has demonstrated that therapeutic singing interventions can not only improve breathing function and speech loudness, but also improve mood and social connectedness for people with quadriplegia. Face-to-face group attendance is difficult for this population due to difficulties with distance and travel. Online environments offer an accessible and cost-effective solution for people to connect with others without leaving their home. In a two-phase iterative design, we explored and tested different approaches for delivering online music therapy sessions with 12 patients from an inpatient spinal cord injury rehabilitation service. Six participants in Phase 1 trialled different virtual reality headsets and completed a short interview about their experience of the equipment and online singing trials. Outcomes from Phase 1 testing led to the development of a custom-built virtual reality application for online group music therapy sessions with low-latency audio. We tested the acceptability and feasibility of this platform in comparison to face-to-face and teleconference options for music therapy with six different patients. These participants completed three validated questionnaires: System Usability Scale, Quebec User Evaluation of Satisfaction with assistive Technology, and Psychosocial Impact of Assistive Devices Scale, and an interview about their experience. Questionnaire scores were good with mean ratings of 4.4 for Quebec User Evaluation of Satisfaction with assistive Technology, 53 for System Usability Scale and positive mean Psychosocial Impact of Assistive Devices Scale scores of 1.5 for competence, 2 for adaptability and 1.5 for self-esteem. Thematic analysis of post-session qualitative interviews revealed five themes: virtual reality was a positive experience, virtual reality was immersive and transportative, virtual reality reduced inhibitions about singing in front of others, virtual reality may reduce social cues, and the virtual reality equipment was comfortable, accessible and easy to use. Telehealth options, including a custom-designed virtual reality program, with low-latency audio are an acceptable and feasible mode of delivery for therapeutic singing interventions for people with spinal cord injury. Future non-inferiority research is needed to test online delivery modes for music therapy in comparison to face-to-face treatment.


Assuntos
Musicoterapia/métodos , Quadriplegia/psicologia , Quadriplegia/reabilitação , Qualidade de Vida/psicologia , Canto , Realidade Virtual , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Inquéritos e Questionários , Resultado do Tratamento , Qualidade da Voz , Treinamento da Voz
18.
Rev. ORL (Salamanca) ; 11(2): 1-5, 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-193774

RESUMO

INTRODUCCIÓN Y OBJETIVO: La distrofia muscular oculofaríngea es una enfermedad genética que afecta a los músculos proximales de las extremidades, ptosis de los párpados y disfagia orofaríngea. En consecuencia, el perfil clínico de estos pacientes podría estar acompañado de disfonía, disartria y pérdida de peso. Las alteraciones de la voz, la articulación y la deglución caracterizan el perfil de la disartrofonía. Se presenta un caso clínico de una paciente con distrofia muscular oculofaríngea que ha sido remitida al servicio de logopedia con el objetivo de rehabilitar su voz. Descripción: La novedad que presenta este caso en la intervención logopédica, es que ha sido rehabilitada mediante técnicas de tracto vocal semiocluído. RESULTADOS: Los resultados obtenidos muestran la efectividad del Lax vox, en la rehabilitación de la paciente. DISCUSIÓN: En la búsqueda bibliográfica hemos encontrado evidencia científica de la efectividad del Lax Vox en pacientes con disfonía, nódulos, pólipos, edemas; pero no hemos encontrado evidencia de la efectividad del Lax Vox en pacientes con distrofia muscular oculofaríngea. CONCLUSIONES: El uso de la técnica Lax vox para la rehabilitación de los pacientes con distrofia muscular óculo-faríngea es beneficiosa


INTRODUCTION AND OBJECTIVE: Oculopharyngeal muscular dystrophy is a genetic disease that affects the proximal muscles of the extremities, ptosis of the eyelids and oropharyngeal dysphagia. Consequently, the clinical profile of these patients could be accompanied by dysphonia, dysarthria and weight loss. The alterations of the voice, the articulation and the swallowing characterize the profile of the disartrofonía. We present a clinical case of a patient with oculo-pharyngeal muscular dystrophy who has been referred to the sevice of speech therapy with the aim of rehabilitating her voice. Description: The novelty that this case presents in the speech therapy intervention is that it has been rehabilitated using semiocluid vocal tract tecniques. RESULTS: The results obtained show the effectiveness of Lax vox in the rehabilitation of the patient. DISCUSSION: In the literature search we have found scientific evidence of the effectiveness of Lax Vox in patients with dysphonia, nodules, polyps, edema; but we have not found evidence of the effectiveness of Lax Vox in patients with oculopharyngeal muscular dystrophy. CONCLUSIONS: With these results, we can conclude that the use of the Lax vox technique for the rehabilitation of patients with oculopharyngeal muscular dystrophy is beneficial


Assuntos
Humanos , Feminino , Adolescente , Testes de Impedância Acústica/métodos , Atrofia Muscular Espinal/diagnóstico , Atrofia Muscular Espinal/cirurgia , Treinamento da Voz , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/terapia
19.
Codas ; 31(6): e20180117, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31800878

RESUMO

PURPOSE: To investigate the immediate effect of phonation into silicone tube on self-assessment and vocal quality of gospel singers. METHODS: The sample was composed of 40 gospel singers without vocal complaint, males and females, from 18 to 40 years. The singers performed semi-occluded vocal tract exercise in LaxVox® silicone tube. The end of the tube was submerged in water (2cm depth), for three minutes. Before and after exercise, voice recording was performed for perceptive-auditory evaluation, and only after exercise, the voice and comfort phonation self-assessments (CSA) were performed. The descriptive and inferential statistical analysis were performed. RESULTS: All participants reported improvement in voice. In addition, a significant higher proportion of them indicated phonation comfort improvement after exercise. According to the perceptive-auditory evaluation, there was no difference in the comparison of the proportions of pre- and post-exercise perceptive-auditory evaluation categories in gospel singers. CONCLUSION: The phonation exercise into a silicone tube caused an immediate positive effect on gospel singers' voice and comfort phonation self-assessments. There was no significant difference in the perceptive-auditory evaluation before and after phonation into silicone tube in gospel singers.


Assuntos
Fonação , Treinamento da Voz , Voz/fisiologia , Acústica , Adolescente , Adulto , Feminino , Humanos , Masculino , Estudos Prospectivos , Autoavaliação , Silicones , Canto , Qualidade da Voz , Adulto Jovem
20.
J Laryngol Otol ; 133(12): 1097-1102, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31791428

RESUMO

BACKGROUND: Disorders of voice can limit an individual's participation and impair social interaction, thus affecting overall quality of life. Perceptual and objective evaluations can provide the clinician with detailed information regarding voice disorders. METHODS: This study comprised 40 subjects aged 34-46 years, 20 of whom (10 male, 10 female) had unilateral vocal fold palsy. Data were obtained for all participants from: the Voice Handicap Index, the grade, roughness, breathiness, asthenia and strain ('GRBAS') scale, acoustic voice analysis, electroglottography, and voice range profiles. RESULTS: The voice evaluations revealed statistically significant (p < 0.05) differences between the controls and study group, both in males and females, pre- and post-therapy. CONCLUSION: Despite the normalisation of vocal parameters, acoustic, perceptual and self-rated assessments revealed statistically significant differences after therapy. Hence, acoustic measures, namely electroglottographic perturbation, and voice frequency and intensity range, are recommended prior to termination of therapy.


Assuntos
Paralisia das Pregas Vocais/fisiopatologia , Distúrbios da Voz/fisiopatologia , Adulto , Autoavaliação Diagnóstica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Recuperação de Função Fisiológica , Índice de Gravidade de Doença , Acústica da Fala , Resultado do Tratamento , Paralisia das Pregas Vocais/complicações , Paralisia das Pregas Vocais/psicologia , Voz , Distúrbios da Voz/etiologia , Distúrbios da Voz/psicologia , Qualidade da Voz , Treinamento da Voz
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