Antonio Augusto de Lima Pontes

Importance of glottic configuration in the development of posterior laryngeal granuloma.

Posterior laryngeal granuloma is frequently related to 3 predisposing factors: vocal abuse, gastroesophageal reflux disease, and orotracheal intubation. It is strongly predominant in men and rare in women, except under postintubation circumstances, in which the incidence is higher in women. The aim of this study was to characterize laryngeal conformations for each sex that, whenever associated with different causes, may lead to the onset and particular location of granulomas, according to a main predisposing factor. Sixty-six subjects whose ages ranged from 18 to 73 years were studied. They were distributed into 4 groups according to the predominant cause of granuloma: intubation, vocal abuse, gastroesophageal reflux, and idiopathic causes. The larynx was evaluated during breathing, and the glottic proportion (GP) was measured. Glottic proportion is the mathematical ratio between the midsagittal dimension of the intermembranous region and that of the intercartilaginous region of the larynx during inhalation. Its measurement was feasible in 57 patients. The groups that had a causative factor other than laryngeal orotracheal intubation had GP values statistically similar to those of each other and to the control group of men, ie, close to 1.2. The postintubation group had GP values similar to the control group of women, ie, close to 1.0; this proportion protects the arytenoid region in womens larynges when there is effort during vocal production, but makes women susceptible to orotracheal postintubation granuloma.

Transfer function of Brazilian Portuguese oral vowels: a comparative acoustic analysis

The vocal tract transfers its characteristics onto the sounds produced at the glottis, depending on its tridimensional configuration. Aim: this study aims to...

Radiotherapy for early glottic cancer and salvage surgery after recurrence

UNLABELLED Early glottic cancer can be effectively treated with radiation or surgery, but recurrence is a possibility when using any of the treatment modalities. AIM To assess the outcome of radiotherapy as initial treatment in the control of squamous cell carcinoma of vocal cord (T1) and the effectiveness of salvage surgery (endoscopic or open) after treatment failure. MATERIALS AND METHODS A retrospective study was based on the analysis of medical records from 43 patients with T1 squamous cell carcinoma of the glottis, radiotherapy as initial treatment and follow-up period of five years. RESULTS The rate of recurrence after radiotherapy was 30.2% of the cases, mean diagnosis interval was 29.5 months. As an option for salvage treatment, patients underwent open partial laryngectomy or endoscopic surgery with control rates of 77.7% and 25% respectively. CONCLUSION Our cases showed high rates of recurrence after radiotherapy and open partial laryngectomy was more effective for the salvage surgery.

Vocal Symptoms and Associated Risk Factors between Male and Female University Teachers

Introduction  Many recent studies on teachers warn of the adverse effects that voice problems have on work performance. However, only a few of these studies included university teachers. Objective  To compare the vocal symptoms and risk factors between male and female university teachers in a private institution within the city of São Paulo. Methods  In a cross-sectional survey, a voice self-evaluation form prepared by the Ministry of Labor in Brazil was administered to 846 university teachers at a private institution in the city of São Paulo. Results  The percentage of hoarseness, vocal tract discomfort, neck pain and foreign body sensation was significantly higher in female than in male subjects. A significantly higher percentage of males participated in other professional activities in addition to teaching, reported working in a calm environment compared with working in a moderately or severely tense and stressful environment, and rated themselves as calm, slightly stressed and anxious or moderately stressed and anxious rather than very stressed and anxious. A significantly higher percentage of females spent most of their time teaching compared with performing other professional activities, and rated themselves as chatty or impulsive. Conclusion  Among university teachers, a significantly higher percentage of females than males reported hoarseness, vocal tract discomfort, neck pain and foreign body sensation. Some risk factors related to work organization, workplace environment, voice care and quality of life variables were related to this higher prevalence in females.