Vocal Alterations Research Articles

Objective Evaluation of Presbyphonia: Spectroacoustic Study on 142 Patients with Praat

Presbyphonia is the sequence of physiological events related to the process of senility of the vocal folds. The aim of our analysis was to provide deeper knowledge of presbyphonia, raising awareness of this condition as well as giving basic suggestions on how to treat related vocal alterations. This is a randomized study. In 2015, we conducted a study on 182 subjects. Each participant underwent an ENT examination (video-laryngo-stroboscopy and subjective acoustic analysis using the General degree of dysphonia; degree of voice Instability; degree of voice Roughness; degree of voice Breathiness; degree of voice Asthenia; degree of voice Strain (GIRBAS) scale) and a logopedic examination (anamnesis, medical history, and acoustic voice analysis using the free software Praat). The comparison between the voice of young people and the seniors showed significant differences for the following Praat-analyzed acoustic parameters: modal fundamental frequency (F0) in women (P < 0,0001), fraction of locally unvoiced frames (P < 0,0001), number of voice breaks (P < 0,0001), jitter local (P < 0,0001), jitter local abs (P < 0,0001), jitter rap (P < 0,0001), jitter ppq5 (P < 0,0001), shimmer local (P < 0,0001), shimmer local dB (P < 0,0001), shimmer apq3 (P < 0,0001), shimmer apq5 (P < 0,0001), mean N/H (P < 0,0001), and mean H/N (P < 0,001), for both sexes. The Praat was confirmed to be a useful tool to detect the existence of the variation of the speech parameters in relation to aging and to quantify statistically significant differences that show a general deterioration in the voice quality, defined numerically. This might lead to a phoniatric treatment or speech therapy, which could improve patients' quality of life, leading to better vocal performance and social and communicative interaction.

Perceptual-auditory and Acoustic Analysis of Air Traffic Controllers' Voices Pre- and Postshift

To characterize the vocal quality and acoustic parameters of voices of air traffic controllers (ATCs) without any vocal complaints before and after a shift. The voices of a group of 45 ATCs were recorded before and after a 2-hour shift, regardless of their operational position or number of previously worked shifts; both genders were included, participants had a mean age of 25 years, and they had a mean length of occupational experience of 4 years and 2 months. Each of these professionals was recorded phonating a sustained /a/ vowel and counting from 1 to 20, and the recordings were acoustically analyzed using the Praat software. A perceptual-auditory analysis of the recordings was then performed by three speech therapists specializing in voice, who evaluated the characteristics of each emission using a visual analog scale (VAS). The acoustic analysis was performed on the sustained /a/ vowel. The measures of intensity; frequency; maximum phonation time (MPT); and the first, second, third, and fourth formants were considered in this analysis. There were no significant differences between the random pre- and postshift samples, either in the acoustic or in the perceptual-auditory analysis. The perceptual-auditory analysis revealed that 44% (n = 20) of ATCs showed alterations in vocal quality during the sustained /a/ vowel emission, and this dysphonia was also observed in connected speech in 25% (n = 5) of this group. Perceptual-auditory analysis of the /a/ vowel revealed that a high percentage of ATCs had vocal alterations (44%), even among a group of subjects without vocal complaints.

Executives' speech expressiveness: analysis of perceptive and acoustic aspects of vocal dynamics.

To analyze speech expressiveness in a group of executives based on perceptive and acoustic aspects of vocal dynamics. Four male subjects participated in the research study (S1, S2, S3, and S4). The assessments included the Kingdomality test to obtain the keywords of communicative attitudes; perceptive-auditory assessment to characterize vocal quality and dynamics, performed by three judges who are speech language pathologists; perceptiveauditory assessment to judge the chosen keywords; speech acoustics to assess prosodic elements (Praat software); and a statistical analysis. According to the perceptive-auditory analysis of vocal dynamics, S1, S2, S3, and S4 did not show vocal alterations and all of them were considered with lowered habitual pitch. S1: pointed out as insecure, nonobjective, nonempathetic, and unconvincing with inappropriate use of pauses that are mainly formed by hesitations; inadequate separation of prosodic groups with breaking of syntagmatic constituents. S2: regular use of pauses for respiratory reload, organization of sentences, and emphasis, which is considered secure, little objective, empathetic, and convincing. S3: pointed out as secure, objective, empathetic, and convincing with regular use of pauses for respiratory reload and organization of sentences and hesitations. S4: the most secure, objective, empathetic, and convincing, with proper use of pauses for respiratory reload, planning, and emphasis; prosodic groups agreed with the statement, without separating the syntagmatic constituents. The speech characteristics and communicative attitudes were highlighted in two subjects in a different manner, in such a way that the slow rate of speech and breaks of the prosodic groups transmitted insecurity, little objectivity, and nonpersuasion.

Vocal warm-up and breathing training for teachers: randomized clinical trial.

OBJECTIVE To compare the effectiveness of two speech therapy interventions, vocal warm-up and breathing training, focusing on teachers’ voice quality.METHODS A single-blind, randomized, parallel clinical trial was conducted. The research included 31 20 to 60-year old teachers from a public school in Salvador, BA, Northeasatern Brazil, with minimum workloads of 20 hours a week, who have or have not reported having vocal alterations. The exclusion criteria were the following: being a smoker, excessive alcohol consumption, receiving additional speech therapy assistance while taking part in the study, being affected by upper respiratory tract infections, professional use of the voice in another activity, neurological disorders, and history of cardiopulmonary pathologies. The subjects were distributed through simple randomization in groups vocal warm-up (n = 14) and breathing training (n = 17). The teachers’ voice quality was subjectively evaluated through the Voice Handicap Index (Índice de Desvantagem Vocal, in the Brazilian version) and computerized voice analysis (average fundamental frequency, jitter, shimmer, noise, and glottal-to-noise excitation ratio) by speech therapists.RESULTS Before the interventions, the groups were similar regarding sociodemographic characteristics, teaching activities, and vocal quality. The variations before and after the intervention in self-assessment and acoustic voice indicators have not significantly differed between the groups. In the comparison between groups before and after the six-week interventions, significant reductions in the Voice Handicap Index of subjects in both groups were observed, as wells as reduced average fundamental frequencies in the vocal warm-up group and increased shimmer in the breathing training group. Subjects from the vocal warm-up group reported speaking more easily and having their voices more improved in a general way as compared to the breathing training group.CONCLUSIONS Both interventions were similar regarding their effects on the teachers’ voice quality. However, each contribution has individually contributed to improve the teachers’ voice quality, especially the vocal warm-up.

Regressão logística como modelo de decisão para a disfonia em professores e não professores

Distúrbios da voz; Sinais e sintomas; Docentes; Modeloslogísticos

Objective and subjective analysis of women's voice with idiopathic Parkinson's disease

To compare the voice quality of women with idiopathic Parkinson's disease and those without it. An evaluation was performed including 19 female patients diagnosed with idiopathic Parkinson's disease, with an average age of 66 years, and 27 women with an average of 67 years-old in the Control Group. The assessment was performed by computed acoustic analysis and perceptual evaluation. Parkinson's disease patients presented moderate rough and unstable voice quality. The parameters of grade, roughness, and instability had higher scores in Parkinson's disease patients with statistically significant differences. Acoustic measures of Jitter and period perturbation quotient (PPQ) significantly differ between groups. Parkinson's disease female individuals showed more vocal alterations compared to the Control Group, when both perceptual and acoustic evaluations were analyzed.

Psychometric assessments of life quality and voice for teachers within the municipal system, in Bauru, SP, Brazil

Studies show a high prevalence of vocal alterations among teachers. One of the criteria for the establishment of the prevalence of vocal alteration is based on teachers' self-perception.ObjectiveThis study aimed at comparing voice-disordered quality of life measures between a group of teachers who reported vocal alteration and a group of teachers who did not, by verifying the teachers' perception regarding the impact of vocal alteration in the different dimensions of voice quality of life. Material and MethodsNinety-seven (97) teachers answered three psychometric protocols of voice quality of life: Voice Handicap Index (VHI), Voice-Related Quality of Life (V-RQOL), and the Voice Activity Participation Profile (VAPP), in addition to a questionnaire for characterization of the sample. ResultsThe results were that 39.8% of the teachers reported vocal alteration. When comparing voice measures between the groups (with and without vocal alteration), statistically significant differences were observed: the total score of VHI, total score of V-RQOL and total score of VAAP and its dimensions. It was also verified that the physical dimension of VHI has a greater impact among the dimensions of this protocol. For VRQOL, the most striking dimension was the physical functioning domain, both indicating the laryngeal discomfort and the impact of voice on communication, in teachers with and without complaints. As for VAAP, no domain prevailed over the others in the group with no complaints. For teachers with complaints, three domains, i.e., daily communication, work, and emotions have a greater impact than social communication. The limitation and restriction scores were calculated as well, and it was observed the limitation of activities is greater than the restriction of activities, both in the group with and the group without complaints. ConclusionOne may conclude that the teachers who reported vocal alterations better realize the impact of voice in different dimensions of voice quality of life.

Disfonia infantil: hábitos prejudiciais à voz dos pais interferem na saúde vocal de seus filhos?

OBJETIVO: verificar hábitos prejudiciais à voz referidos por crianças disfônicas e por seus respectivos pais e mães e compará-los com dados obtidos de um grupo controle, constituído por crianças sem alterações vocais e seus respectivos pais e mães. MÉTODO: investigou-se 28 crianças disfônicas, com idade entre 6 e 12 anos e seus pais (Grupo de Estudo - GE) e 22 crianças sem alterações vocais, com a mesma faixa etária, e seus respectivos pais (Grupo Controle - GC). As vozes foram classificadas em "alteradas" e "não alteradas" por meio de análise perceptivo-auditiva com amostra da fala espontânea.Todos responderam a um questionário sobre fatores prejudiciais à voz. Para análise dos resultados foram aplicados os testes de comparação de duas proporções (p&lt;0,05). RESULTADOS: verificou-se que as crianças do GE apresentaram significantemente mais os hábitos: falar com esforço, falar sem descansar e imitar vozes. Os pais do GE relataram significantemente mais hábitos de: pigarrear, gritar, falar junto com os outros, além de viver em ambiente de fumantes. As mães do GE apresentaram significantemente mais hábitos de: falar com esforço, falar em ambiente ruidoso e falar muito rápido. Viver em ambiente familiar ruidoso foi significantemente mais relatado por crianças, pais e mães do GE quando comparados aos do GC. CONCLUSÃO: independentemente de fatores que possam justificar a disfonia, crianças disfônicas e seus pais e mães relataram maior ocorrência de hábitos prejudiciais à voz e viver em ambiente familiar ruidoso do que crianças sem alterações vocais e seus respectivos pais e mães.

Sintomas vocais e sensações laríngeas em trabalhadores de uma usina de álcool e açúcar expostos a riscos ocupacionais

OBJETIVO: Investigar os sintomas vocais e sensações laríngeas dos trabalhadores de uma usina de álcool e açúcar expostos a ruído e/ou substâncias químicas. MÉTODOS: Participaram 289 trabalhadores de uma usina de álcool e açúcar distribuídos em cinco grupos expostos (I- ruído; II- ruído, óleo, graxa, derivação de petróleo; III- ruído, ácidos, sulfatos, cloretos, nitratos; IV- ruído, poeiras respiráveis e sílica livre cristalizada; V- óleo, graxa, derivação de petróleo) e um grupo controle que responderam o questionário Condições de Produção Vocal - Professor adaptado à categoria profissional. Os grupos foram comparados em relação aos sintomas vocais, sensações laríngeas, tabagismo e riscos físicos e químicos. Esta comparação foi realizada por meio de análise estatística. RESULTADOS: O sintoma vocal e a sensação laríngea mais relatados pelos trabalhadores foram voz grave e tosse com catarro, respectivamente. Considerando o risco físico no ambiente de trabalho, os grupos I e IV foram os que mais citaram presença de ruído. Devido à sua exposição, os mesmos aumentavam a intensidade da voz (Efeito de Lombard-Tarneaud) e, assim, mencionaram sintomas vocais. Em relação aos riscos químicos no ambiente ocupacional, o grupo IV foi o que mais referiu presença de poeira e fumaça, e estas eram compostas por poeiras respiráveis e sílica. Tais exposições ocasionam sintomas vocais e sensações laríngeas e, consequentemente, alterações vocais. CONCLUSÃO: Sintomas vocais e sensações laríngeas podem estar relacionados a atividade profissional em que haja exposição a riscos físicos e/ou químicos.

Relação entre dados ocupacionais, sintomas e avaliação vocal de operadores de telesserviços

OBJETIVO: Relacionar dados referentes a gênero, idade e tempo na função com os sintomas vocais e os resultados da avaliação vocal de operadores de telesserviços. MÉTODOS: Foi realizada análise retrospectiva e quantitativa de 404 prontuários referentes a avaliações periódicas de funcionários de instituições bancárias com centrais próprias constantes no arquivo de uma empresa de medicina ocupacional, 259 mulheres, 145 homens, com idades entre 18 e 53 anos (média 30,48). O estudo teve caráter exploratório descritivo. RESULTADOS: Mulheres apresentam maior quantidade de sintomas vocais (média 1,69) e alteração de voz (n=33; 12,7%) do que homens (média 1,12 e n=6; 4,1%). Não houve diferença entre quantidade de sintomas vocais e dados da avaliação perceptivo-auditiva quando relacionados à faixa etária e tempo na função. Funcionários com vozes neutras (n=365; 90,35%) apresentaram menor número de sintomas (1,41) que funcionários com vozes não neutras (n=39, 9,65%, média 2,21). Dos 39 funcionários com qualidade vocal não-neutra, 34 (87,2%) apresentaram ressonância laringo-faríngea e 21 (53,8%) apresentaram pitch agravado. Operadores com alteração vocal de grau moderado (n=12; 2,97%) apresentaram maior ocorrência de loudness aumentada em relação aos operadores com alteração discreta. CONCLUSÃO: Mulheres apresentam maiores índices de sintomas e alteração de voz. Não há relação entre o avanço da idade e maior tempo na função do teleoperador com o aumento do número de sintomas e alterações vocais. Alterações de pitch, loudness e ressonância têm relação com alterações de qualidade vocal.

Combined Injury of the Accessory Nerve and Brachial Plexus

Stretch-induced spinal accessory nerve palsy has been considered extremely rare, with only a few cases reported. In 357 patients with stretch lesions of the brachial plexus, we investigated the prevalence, course, and surgical treatment of accessory nerve palsy. Accessory nerve palsy was ascertained when the patient was unable to shrug the ipsilateral shoulder. Patients underwent brachial plexus reconstruction between 6 and 8 months after trauma. To confirm paralysis, during surgery, the accessory nerve was stimulated electrically. Accessory nerve palsy occurred in 19 of the 327 patients (6%) with upper type or complete palsy of the brachial plexus. Proximal injuries of the accessory nerve accompanied by voice alteration and complete palsy of the sternocleidomastoid and trapezius muscle occurred in 2 patients. Proximal palsy without vocal alterations was observed in 6 patients. Palsy of the trapezius muscle with preservation of the sternocleidomastoid muscle occurred in 11 patients. All 7 patients who demonstrated muscle contractions upon electrical stimulation of the accessory nerve during surgery recovered completely. Patients with surgical reconstruction of the accessory nerve through grafting (n = 2) or repair by platysma motor nerve transfer (n = 2) recovered active shoulder shrugging within 36 months of surgery. Seven of the 8 patients without accessory nerve reconstruction recovered from their drop shoulder and head tilt, but remained unable to shrug. If intraoperative electrical stimulation produces contraction of the upper trapezius muscle, no repair is needed. In proximal injuries, the platysma motor branch should be transferred to the accessory nerve; whereas in paralysis distal to the sternocleidomastoid muscle, the accessory nerve should be explored and grafted.

Descrição da dinâmica de alimentação de idosas institucionalizadas

OBJETIVO: Descrever a dinâmica alimentar de idosas institucionalizadas no que se refere aos aspectos clínicos de deglutição, cognitivos, comportamentais e ambientais ligados à alimentação. MÉTODOS: Realizou-se um estudo observacional transversal prospectivo, que descreveu a dinâmica de alimentação de 30 idosas residentes numa instituição de longa permanência. Alguns dos aspectos analisados foram registrados por observadores no momento da alimentação e outros em filmagem da refeição de cada idosa. Os dados foram apresentados de forma descritiva e comparados à literatura. RESULTADOS: A média de idade foi 83,7 anos. Os diagnósticos médicos mais prevalentes foram síndrome demencial e hipertensão arterial sistêmica. Foram observados: ingestão oral pobre em 73,3% das idosas, tempo médio de alimentação de 10,1 minutos, posicionamento inadequado em 46,7% das refeições, alterações atitudinais em 16,7% e comportamentais em 40% das idosas. A assistência foi requerida por 56,6% das idosas, tendo sido provida a 70,6% desses casos, e julgada inadequada em 66,6% deles. Eram edêntulas 44,4% das idosas, das quais 46,1% utilizavam prótese dentária total, sendo predominante a inadequação da adaptação, do estado de conservação e da higiene (83,4%). A prevalência de alterações de deglutição foi igual a 23,3%, sendo as mais prevalentes os resíduos alimentares após a deglutição, tosse durante a alimentação e alteração vocal após a deglutição. CONCLUSÃO: Verificou-se presença significativa de fatores ambientais, cognitivos e comportamentais ligados à alimentação que podem oferecer risco à deglutição. Também se identificaram outras alterações específicas da deglutição, cujo gerenciamento é importante para evitar complicações da saúde destas idosas.

UltraCision harmonic scalpel versus clamp‐and‐tie total thyroidectomy: A clinical trial

Hemostasis is important in thyroid surgery to avoid complications. Our aim was to evaluate the effectiveness of the harmonic scalpel in patients undergoing total thyroidectomy. In this study, 90 patients were randomized into group A (classic technique of tying and knots) and group B (harmonic scalpel). We recorded the following: age, sex, pathology, thyroid weight, hemostatic technique, duration of operation, change in calcemia (DeltaCa), change in hematocrit (DeltaHt), change in hemoglobin (DeltaHgb), change in white blood cell count (DeltaWBC), vocal motility, operative difficulty, postoperative vocal alteration, postoperative pain, complications, blood in the drains, operating time, mass of gland excised per minute, and hospitalization. Differences (p < .05) were observed concerning duration of surgery, operative difficulty, postoperative pain, hospitalization, DeltaWBC, and quantity of gland removed per minute. No recurrent laryngeal nerve (RLN) palsies were observed. Use of the Harmonic Scalpel in total thyroidectomy is more effective than the clamp-and-tie technique: the duration of surgery, intraoperative difficulty, postoperative pain, and hospitalization are reduced. Both techniques are equivalent concerning RLN injuries, postoperative vocal alterations, and blood loss.

Laryngeal vocal and endoscopic alterations after thyroidectomy under local anesthesia and hypnosedation

Vocal alterations after thyroidectomy are generally related to laryngeal nerve injury or laryngotracheal mobility disorders caused by postoperative fibrosis ...

Laryngeal vocal and endoscopic alterations after thyroidectomy under local anesthesia and hypnosedation

SummaryVocal alterations after thyroidectomy are generally related to laryngeal nerve injury or laryngotracheal mobility disorders caused by postoperative fibrosis or strap muscle lesion.Aimthis study aims to evaluate the frequency of vocal and rima glottidis disorders after thyroidectomy.Materials and methodThis is a prospective study based on 35 patients submitted to thyroidectomy under local anesthesia and hypnosedation. All patients underwent voice auditory perception evaluation, voice acoustic tests and videolaryngostroboscopy preoperatively, and at one week and at 30 days postoperatively. Bilateral cricothyroid muscle electromyography was performed on the thirtieth day after surgery to confirm the presence of injury in the external branch of the superior laryngeal nerve.Results14.3% of the patients presented posterior glottis deviation before surgery and normal electromyography findings. Transient and permanent vocal alteration occurred in 25.7% and 14.2% of the patients respectively.Conclusionvoice disorders evaluated after voice auditory perceptive evaluation and voice acoustic tests were more intense in the group with superior laryngeal nerve external branch injury than in the injury-free dysphonic patient group. Oblique glottis can be present in normal patients; however its onset after thyroidectomy is indicative of superior laryngeal nerve external branch lesion.

Frequência fundamental de crianças da cidade de Niterói

OBJETIVO: medir a frequência fundamental de 122 crianças de seis a oito anos de idade, meninos e meninas, sem alterações vocais, avaliadas por meio da escala Rasat. MÉTODOS: a análise perceptivo-auditiva foi realizada através da escala RASAT e para a análise acústica computadorizada foi utilizado o programa de software Vox Metria, analisando-se a média da frequência fundamental de amostras da vogal [ε] sustentada. Participaram deste estudo 122 crianças, 58 meninos e 64 meninas com idade variando de seis a oito anos e 11 meses de idade do ensino fundamental, da Rede Municipal de Niterói-RJ, nascidos e residentes na cidade, pré-selecionadas através de um protocolo de triagem. RESULTADOS: os resultados obtidos neste estudo foram: frequência fundamental média de 239,60 Hz para as meninas e 237,17 Hz para os meninos, obtendo-se uma média geral de 238,44 Hz. CONCLUSÃO: conclui-se que os achados permitiram a comparação com resultados de pesquisas realizadas anteriormente, contribuindo com novos dados para a padronização da frequência fundamental das vozes infantis brasileiras.

Caracterização dos indivíduos com distúrbios da fluência, atendidos na clínica-escola do curso de fonoaudiologia da USP-Bauru

OBJETIVO: caracterizar a população de indivíduos atendidos na Clínica de Distúrbios da Fluência do Curso de Fonoaudiologia da USP (Bauru), de 1992 a 2005, quanto à idade, gênero, queixa inicial, diagnóstico fonoaudiológico, antecedentes familiares, manifestações, gravidade e frequência, além de possíveis alterações associadas, comparando tais dados com a literatura estudada. MÉTODOS: análise de 194 prontuários da população acima referida por meio do preenchimento de protocolo com questões referentes às variáveis propostas no objetivo. RESULTADOS: dos 194 prontuários, 140 pertenciam a pacientes do sexo masculino (72% da amostra) e 54 (28%), do feminino. Entre as queixas relatadas, 68% (n=132) eram de gagueira, 23% (n=45) referiam-se a outros distúrbios da fluência (taquifemia, distúrbio motor da fala) e outras 9% (n=17) estavam associadas a alterações vocais, linguagem oral e/ou escrita e fala. Quanto a antecedentes familiares, 57% (n=110) tinham na família mais de um parente com alterações na fala e/ou linguagem. As manifestações das disfluências, citadas em 54% dos prontuários (n=105) dos indivíduos diagnosticados com gagueira, foram bloqueios, repetições e prolongamentos. Constatou-se histórico de atraso de linguagem nos casos de gagueira em 31% dos casos (n=60). CONCLUSÃO: com base nos dados encontrados, conclui-se que a população estudada caracteriza-se por apresentar: início dos primeiros sintomas entre 1 e 5 anos, maior acometimento no gênero masculino, histórico familiar e de atraso de fala e linguagem positivo, manifestações predominantes de repetição de sílabas, bloqueios, bloqueios acompanhados de prolongamentos e hesitações.

Auditory voice-perception analysis sensitivity and specificity in the screening of laryngeal disorders

SummaryDespite the growing experience obtained from the National Pro-Voice Campaigns in screening individuals with laryngeal alterations, we still have not established which would be the best assessment method: speech and hearing screening alone, laryngoscopy alone, or a joint work with physicians and speech therapists doing the screening together.Aimthe goal of the present study was to assess the sensitivity, specificity, positive and negative predictive values of the auditory voice-perception analysis compared to videolaryngoscopy as a screening method for individuals with laryngo-pharyngeal disorders.Materials and MethodsWe compared the vocal aspects (GRBASI scale, pitch, loudness, CPF and resonance) and videolaryngoscopic from 567 individuals who participated in the National Pro-Voice Campaign 2005 in a tertiary university hospital.Resultsthe most frequent laryngeal alteration was laryngo-pharyngeal reflux (LFR) (43.5%), followed by benign lesions (17%) and suspected malignant lesions (1%). The sensitivity of the auditory voice-perception assessment was of 91% for patients with benign lesions and 100% in those with suspected malignant lesions; however, it was only 76% in LFR. Of those tests considered normal, there were vocal alterations in 52%. The positive predictive value was of 71% and the negative was 61%.ConclusionsDespite its importance, the auditory voice-perception assessment should not be used as a single screening instrument in voice health campaigns.

Epidemiological study on vocal disorders in paediatric age.

Few studies analyzed the diffusion of vocal alterations especially in childhood. Aim of our study was to quantify the numbers of subjects, in paediatric age, in which dysphonia was diagnosed in our department of Phoniatrics, during a period of 5 years, (January 2002-December 2006), and also to evaluate the influence of some potential risk factors. In the considered period it emerged that the diagnosis of dysphonia was made in 312 children (17.2% of the patients affected from dysphonia), aged between 2 and 16-years-old, with a major prevalence amongst males (57%) than females (43%). On the contrary in the adult population the prevalence was: 23% in males and 77% in females. In paediatric population, the most affected range of age is the one between 8 and 14, in both male and female gender (59.6%). In 82.4% of the cases there were vocal fold lesions. The 90.3% of children with vocal fold alterations presented lesions secondary to vocal abuse and misuse and classifiable as functional dysphonia. The proportion of functional dysphonia in our sample was 92%. The 65% of children belonged to large families with more than two children, and the 30% had a family history of dysphonia (brothers, parents). The study of the behavioural characteristics has shown aggressive and hyperactive attitudes in 83% of the cases. Since in the ethiopathogenesis of the childhood dysphonia the tendency to vocal abuse has a predominant role, it would be useful to encourage the diffusion of programmes of information to show the risks linked to this abuse in children, in order to prevent the development of dysphonia in paediatric age.

Conduta fonoaudiológica e avaliação estroboscópica no diagnóstico diferencial do cisto

OBJETIVO: descrever o trabalho fonoaudiológico, após diagnóstico diferencial do cisto intracordal, por meio do exame de videolaringoestroboscopia associado à fonação inspiratória. MÉTODOS: relato de caso, baseado em dados de anamnese, da avaliação clínica fonoaudiológica, do exame videolaringoestroboscópico e conduta terapêutica específica. RESULTADOS: identificação do cisto intracordal em prega vocal direita com alterações encontradas no exame laringológico, compatível à avaliação clínica fonoaudiológica. Verificou-se que, após conduta direcionada, a paciente obteve melhora na vibração e amplitude da onda mucosa da prega vocal direita, com manutenção de períodos de estabilidade vocal. CONCLUSÃO: a eficiência dos procedimentos depende diretamente das avaliações e diagnósticos precisos dos profissionais envolvidos, o que permite uma conduta direcionada ao caso e, menor tempo de tratamento.