Bruna Franciele da Trindade Gonçalves

As implicações da classe II de angle e da desproporção esquelética tipo classe II no aspecto miofuncional

TEMA: esse trabalho foi baseado na tematica de que existe uma associacao entre as mas oclusoes devido a alteracoes do crescimento craniofacial, e, por conseguinte, a existencia de alteracoes miofuncionais. OBJETIVOS: estudar a associacao entre as mas oclusoes tipo classe II desencadeadas por alteracoes do crescimento craniofacial e as disfuncoes do sistema estomatognatico (alteracoes miofuncionais: fala, mastigacao, degluticao e fonacao). CONCLUSAO: pode-se concluir que alteracoes estruturais da face podem ter influencia na funcionalidade das mesmas, portanto, enfatiza-se a importância do trabalho multidisciplinar entre os profissionais envolvidos em cada uma dessas aereas para que o prognostico desses casos seja pertinente de relevantes melhoras.

Relato de caso: a importância da atuação multiprofissional na laringectomia supracricóide

This study is about theperfomance multiprofissional on laryngectomy supracricoid. The speech therapy in the hospital was carried out twice a day, after 14 sessions, pasty consistency was released. The patient returned to the disfagia outpatient of the hospital, once a week for two months and now returns once a month. Nutritional therapy nasoenteric probe (NEP) allowed the necessary caloric intake and hydration and, through the release of consistency by oral Audiologist, the nutritionist expanded the options of foods that the patient could eat, favoring the profit of weight and withdrawal of the alternative way of feeding.The multiprofessional intervention enabled the degree of oropharyngeal dysphagia mechanical evolve from severe to mild oropharyngeal dysphagia for liquids only, being the evolution of therapy being verified through the patients oral intake, which evolved from a FOIS 1 for FOIS 3 and is currently third in the FOIS 6. The realization of enteral nutrition therapy enabled the patient to regain his usual weight, on three months period, considering that with surgery, it lost 11 kg. It was noted that through the accompaniment multiprofessional, was possible evolve from an exclusive enteral nutrition to oral diet, which favored the evolution of nutritional status, with the recovery of body weight, addition to providing improved quality of life of this person.

Relações entre /s/ e /z/ e entre /e/ e /e/ não vozeado ou áfono

ABSTRACTPurpose : correlate the maximum phonation time (MPT) and the relations between the fricative /s/ and /z/ (s/z) and between the vowels /ė/ and /e/ (ė/e) of women without laryngeal disorders. Method : participants were 60 women with a mean of 21.56 years old. Were collected MPT/ė/, /e/, /s/ and /z/ and calculated the relations ė/e and s/z, with normal pattern for the relationship from 0.8 to 1.2; for MPT/s/ and MPT/z/, between 15.57 and 34.17s; for the MPT/ė/, between 16 to 18s; and for the MPT/e/, between 14.04 and 26.96s. Lilliefords, Spearman, Binomial and Mann-Whitney tests with a significance level of 5%. Results: positive correlation between MPT/s/ and MPT/ė/, MPT/z/ and MPT/e/, MPT/s/ and MPT/z/, and MPT/ė/ and MPT/e/. There was no correlation between the ratios s/z and ė/e, no differences between the relative ė/e, while the relation s/z was significantly normal. MPT/ė/ and MPT/e/ significantly reduced; MPT/s/ and MPT/z/ significantly normal. MPT/ė/ significantly lower than MPT/s/; MPT/e/ significantly lower than MPT/z/.

Laryngeal disorders, maximum phonation times and vital capacity in women with organofunctional dysphonia

PURPOSE: to determine and to correlate the maximum phonation times (MPT) of vowels, vital capacity (VC) and laryngeal disorders (LD) for women with benign organic lesions resulting from vocal misuse or abuse (BOL). METHOD: retrospective, transverse, exploratory, non-experimental, quantitative study, with measurement database of MPT [a, i, u], VC and LD of women with BOL, and Chi-Square statistic and exact tests of Fisher in order to investigate the differences between the variables and their relationships and a binomial test in order to check the significance of proportion or percentage of descriptive analysis, with p<0.05. RESULTS: the majority (22; 75.86%) showed MPT significantly reduced (p = 0.0053) and seven (24.14%) normal MPT. The normal VC was statistically significant (p = 0.0001) (26; 89.66%), but three women (10.34%) showed it to be reduced. There was significant dominance of vocal nodules (p = 0.0016) (22; 75.86%), followed by Reinkes edema (6, 20.69%) and vocal polyp (1; 3.45%). Among the 22 woman (75.86%) which showed reduced MPT, there was a predominance with normal VC (19; 86.36%), although no statistical significance (p = 0,558). All the individuals with normal MPT showed VC normal (7; 100%). The majority with BOL showed normal VC, although not statistically significant (p=0,199). There was a predominance of vocal nodules and reduced MPT (16; 72.73%), although not statistically significant (p=0.086). In the correlation of the three variables, most of the subjects presented vocal nodules associated with MPT reduced and normal VC (15; 68.18%), although not statistically significant. CONCLUSION: in women with BOL in this study, the reduced MPT, the normal VC and the presence of vocal nodules were significant and there was no relationship between the MPT, VC and LD.Purpose: to determine and to correlate the maximum phonation times (MPT) of vowels, vital capacity (VC) and laryngeal disorders (LD) for women with benign organic lesions resulting from vocal misuse or abuse (BOL). Method: retrospective, transverse, exploratory, non-experimental, quantitative study, with measurement database of MPT [a, i, u], VC and LD of women with BOL, and Chi-Square statistic and exact tests of Fisher in order to investigate the differences between the variables and their relationships and a binomial test in order to check the significance of proportion or percentage of descriptive analysis, with p<0.05. Results: the majority (22; 75.86%) showed MPT significantly reduced (p = 0.0053) and seven (24.14%) normal MPT. The normal VC was statistically significant (p = 0.0001) (26; 89.66%), but three women (10.34%) showed it to be reduced. There was significant dominance of vocal nodules (p = 0.0016) (22; 75.86%), followed by Reinke’s edema (6, 20.69%) and vocal polyp (1; 3.45%). Among the 22 woman (75.86%) which showed reduced MPT, there was a predominance with normal VC (19; 86.36%), although no statistical significance (p = 0,558). All the individuals with normal MPT showed VC normal (7; 100%). The majority with BOL showed normal VC, although not statistically significant (p=0,199). There was a predominance of vocal nodules and reduced MPT (16; 72.73%), although not statistically significant (p=0.086). In the correlation of the three variables, most of the subjects presented vocal nodules associated with MPT reduced and normal VC (15; 68.18%), although not statistically significant. Conclusion: in women with BOL in this study, the reduced MPT, the normal VC and the presence of vocal nodules were significant and there was no relationship between the MPT, VC and LD.

Tempo máximo de fonação /a/, tempo máximo de fonação previsto e tipo respiratório de mulheres adultas sem afecções laríngeas

PURPOSE:to verify the differences between the maximum phonation time /a/ and maximum phonation time predicted in relation to the respiratory type, and correlate the the maximum in adult women with vital capacity within the normal range and without laryngeal affections.METHODS:cross-sectional analytic research, quantitative and retrospective, in the database, 51 female subjects with an otorhinolaryngological diagnosis of absence of laryngeal affections, aged between 18 and 44 years (mean 27.64). It was used: higher value of maximum phonation time /a/, maximum phonation time predicted, vital capacity and respiratory type. The value of maximum time predicted for women, was calculated by multiplying the vital capacity by 0.0051, and the value found was decisive for the classification of phonation time /a/ in normal, below or above expectations.RESULTS:there were significant differences between maximum time predicted and respiratory type superior (17,44s) and mixed (15,17s). No significant difference phonation time /a/ in different and respiratory type, or correlation between phonation time /a/ and maximum time predicted.CONCLUSION:there was no correlation between phonation time /a/ and maximum time predicted and the maximum time predicted was significantly higher in respiratory type superior than in mixed.

Utilização de protocolos de qualidade de vida em disfagia: revisão de literatura

O objetivo deste estudo foi identificar os protocolos existentes sobre qualidade de vida (QV) em disfagia e verificar a utilizacao dos mesmos no tratamento fonoaudiologico. Realizou-se pesquisa teorica e exploratoria com a tecnica de revisao da literatura nas bases de dados SCOPUS, Trip Database, LILACS, PubMed, SciELO, Google Schoolar, periodicos Capes e MedLine. O periodo de busca compreendeu os anos entre 2004 e 2014 e foram utilizados os seguintes descritores: degluticao; transtornos da degluticao; qualidade de vida; questionarios e os seus respectivos termos em ingles deglutition; deglutition disorders; quality of Life; questionnaires. Foram encontrados na literatura o protocolo Quality of life in Swallowing Disorders-SWAL-QOL, o qual estabelece o comprometimento da degluticao independente da etiologia; o MD Anderson Dysphagia Inventory, que e especifico para sujeitos submetidos a tratamento de câncer de cabeca e pescoco e o Dysphagia Handicap Index,que avalia os efeitos da disfagia sobre a qualidade de vida (QV) em sujeitos com diferentes patologias de base e pode ser utilizado em niveis mais baixos de escolaridade. A literatura propoe diferentes protocolos que avaliam a QV em disfagia, sendo que os mais utilizados avaliam a QV de forma geral, relacionada ao câncer de cabeca e pescoco e de sujeitos com diferentes diagnosticos medicos. A utilizacao desses protocolos pode auxiliar e complementar a avaliacao clinica e objetiva da degluticao, uma vez que, retratam a autoavaliacao referida pelo sujeito, sendo este ponto de vista de extrema importância para o tratamento fonoaudiologico.

Relationship between Dysphagia and Exacerbations in Chronic Obstructive Pulmonary Disease: A Literature Review

Introduction The literature presents studies correlating chronic obstructive pulmonary disease to dysphagia and suggesting that the aspiration laryngeal phenomenon related to changes in the pharyngeal phase contributes significantly to the exacerbation of symptoms of lung disease. Objectives This study aimed to conduct a literature review to identify the relation between dysphagia and exacerbations of chronic obstructive pulmonary disease. Data Synthesis We found 21 studies and included 19 in this review. The few studies that related to the subject agreed that the presence of dysphagia, due to lack of coordination between swallowing and breathing, may be one of the triggering factors of chronic obstructive pulmonary disease exacerbation. Conclusions The review noted that there is a relationship between dysphagia and exacerbations of chronic obstructive pulmonary disease, identified by studies demonstrating that the difficulties associated with swallowing may lead to exacerbation of the disease. There was difficulty in comparing studies by their methodological differences. More research is needed to clarify the relationship between dysphagia and exacerbations of chronic obstructive pulmonary disease, making it possible to develop multiprofessional treatment strategies for these patients, catered to specific needs due to the systemic manifestations of the disease.

Qualidade de vida em voz na doença pulmonar crônica

Purpose: analyzing the quality of life related to self-reported voice by individuals with Chronic Pulmonary Disease. Methods: cross, exploratory and quantitative study with information obtained from the application of Quality of Life and Voice questionnaire with users an integrated physiotherapy clinic in a university hospital in the interior of Rio Grande do Sul, in the period from March to November 2012. Results: 19 subjects participated in the study, 12 (63.20%) were males and 7 (36.80%) were females. On the age group, 14 (73.70%) were adults and five (26.30%) elderly, a statistically significant difference. As for the Chronic Pulmonary Disease, ten (52.60%) had bronchiectasis, six (31.60%) had Chronic Obstructive Pulmonary Disease and three (15.80%) asthma. The average of Quality of Life and Voice questionnaire was 85.8 ± 5.8 points. There was no statistical difference between the three areas of Quality of Life and Voice questionnaire and the genre, age and medical diagnosis. Conclusion: percentage predominance of males and adult-aged age group, the latter being statistically significant and medical diagnosis of bronchiectasis. The average of the total questionnaire was 85.8 ± 5.8 points. There was no statistical significance in the comparison in questionnaire areas with the genre, age and lung disease. This can be explained by the development of communication strategies in order to minimize the effects of the Chronic Pulmonary Disease on voice. We suggest the completion of other studies addressing the same theme, but with larger samples to check the statistical significance of the studied variables.

Resultados vocais perceptivoauditivos após Tireoplastia tipo I e fonoterapia em um caso de paralisia de prega vocal

Verificar as modificacoes vocais perceptivoauditivas apos intervencao cirurgica e fonoterapeutica. Relato de caso de homem de 32 anos de idade, com paralisia de prega vocal direita decorrente de traumatismo cranioencefalico por arma de fogo, submetido a Tireoplastia tipo I e a seis sessoes de fonoterapia. Avaliacao vocal perceptivoauditiva da fala espontânea por meio da escala RASATI e dos aspectos: pitch e ressonância, realizada antes e apos a cirurgia e apos a fonoterapia. Os audios foram analisados por tres fonoaudiologas com experiencia em voz e as analises foram consideradas em conjunto para determinar o julgamento predominante em cada parâmetro. A fonoterapia consistiu em: metodo de sobrearticulacao, constricao labial e pontos cardeais com a lingua. Apos a cirurgia, houve melhora da soprosidade (de grau moderado ficou discreto), astenia (de discreto ficou normal), tensao (de moderado ficou discreto) e pitch (de discretamente grave ficou normal); piora do aspecto rouquidao (de discreto ficou moderado) e nao houve modificacoes na instabilidade (permaneceu moderado), ressonância hipernasal (permaneceu intenso), aspereza (normal). Apos a fonoterapia, houve melhora da rouquidao (de moderado ficou normal) e da instabilidade (de moderado ficou discreto). Os demais aspectos nao apresentaram modificacoes. A Tireoplastia tipo I melhorou os aspectos vocais perceptivoauditivos de soprosidade, astenia, tensao e pitch e piorou a rouquidao, sem influenciar a instabilidade e a ressonância; e a fonoterapia melhorou os aspectos de rouquidao e instabilidade. Com isso, enfatiza-se a importância da fonoterapia apos cirurgias laringeas.

Correlation between the reason for referral, clinical, and objective assessment of the risk for dysphagia

PURPOSE To correlate the reason for referral to speech therapy service at a university hospital with the results of clinical and objective assessment of risk for dysphagia. METHODS This is a cross-sectional, observational, retrospective analytical and quantitative study. The data were gathered from the database, and the information used was the reason for referral to speech therapy service, results of clinical assessment of the risk for dysphagia, and also from swallowing videofluoroscopy. RESULTS There was a mean difference between the variables of the reason for the referral, results of the clinical and objective swallowing assessments, and scale of penetration/aspiration, although the values were not statistically significant. Statistically significant correlation was observed between clinical and objective assessments and the penetration scale, with the largest occurring between the results of objective assessment and penetration scale. CONCLUSION There was a correlation between clinical and objective assessments of swallowing and mean difference between the variables of the reason for the referral with their respective assessment. This shows the importance of the association between the data of patients history and results of clinical evaluation and complementary tests, such as videofluoroscopy, for correct identification of the swallowing disorders, being important to combine the use of severity scales of penetration/aspiration for diagnosis.