Karoline Weber dos Santos

Influence of gustatory and olfactory perception in the oral phase of swallowing in smokers

PURPOSE To analyze the difference between nonsmokers and smokers on the changes in the perceptions of smell and taste and to verify the influence of these aspects in the emergence of compensatory movements during swallowing. METHODS To evaluate these aspects, capabilities of olfactory and gustatory recognition were observed, as well as the compensation swallowing. Twenty-four patients were evaluated in each study group aged from 18 years, grouped in a stratified way. The olfactory evaluation consisted in presenting seven essences and one of three options should be chosen. For the taste test, 16 flavors were offered in a non-sequential and decreasing way in amount of solute. Swallowing solid and liquid was evaluated, in which aspects of compensation perioral muscles were observed. RESULTS Worst performance in olfactory and gustatory tests among smokers (p≤0.01) was found. Through the results of χ2 and Fishers exact tests, it was found that the contraction of the mentalis muscle is less observed in non-smokers, and smokers have an average degree of statistically significant change compared to nonsmokers. Furthermore, through the Spearman correlation coefficient, it was found that the worsening in the sensory tests implies increased compensation during swallowing in smokers. CONCLUSION These data allowed us to verify that the sensory changes have influence on swallowing pattern, indicating that these changes are aspects that should be considered in the differential diagnosis of changes in swallowing.PURPOSE To identify the immediate effects of voiced vibration and vocal fry exercises on healthy subjects by means of acoustic parameters and high-speed kymography. METHODS Thirty healthy subjects (18 women and 12 men, aged from 19 to 45 years old) participated in this study. The voices were recorded at the range of 44.100 samples/second, before and after of the vocal exercises. We developed a computational routine to extract jitter and shimmer. High-speed kymography was generated from laryngeal images for the analysis of the phase times: closed (CPh), open (OPh), of closing (cPh) and of opening (oPh) and used the paired t-Student test and the Mann-Whitney test, with a significance level of 0.05. RESULTS After voiced vibrations, acoustic parameters showed reduced jitter for both genders (p=0.018 for men and p<0.01 for women) and reduced shimmer for female voices (p<0.01). There was a decrease in CPh (p=0.046) and cPh (p=0.026) and an increase in OPh (p=0.05) in female vocal folds. After vocal fry, we identified decreased jitter (p<0.01) in female voices and cPh (p=0.026) in male vocal folds. CONCLUSION We observed more positive immediate effects of the voiced vibrations, mainly in voice quality and vocal folds among females. Nevertheless, studies with larger male sample and investigation of the appropriate time of vocal fry are necessary to confirm the results of this search.

Vocal Variability Post Swallowing in Individuals with and without Oropharyngeal Dysphagia

Introduction Voice modification after swallowing may indicate changes in the transit of the bolus. Objective The aim of this study is to verify the use of perceptual voice analysis to detect oropharyngeal dysphagia. Study Design Case series. Methods Twenty-seven patients with dysphagia as diagnosed by videofluoroscopy and 25 without were evaluated. The sustained vowel /a/ was recorded before this exam and after swallowing different consistencies (pasty, liquid and solid). For the voice evaluation, the GRBAS scale (grade, roughness, breathiness, asthenia and strain) and the parameter “wet voice” were used. Three judges blinded to study group and time of emission performed voice analysis. Results Individuals with dysphagia showed significant decrease in grade of voice and asthenia and increase in strain after swallowing pasty substances, differing from individuals without dysphagia who showed no modification of the parameters after swallowing. The wet voice parameter showed no difference after swallowing in both study groups. Conclusion The decrease in grade and asthenia and increased strain are indicative of a swallowing disorder, indicating increased vocal strain to clean the vocal tract of food. The modification of vocal production after swallowing proved to be a trusted resource for detection of swallowing disorders.

Dysfunctions of the stomatognathic system and vocal aspects in Fahr disease: case report

The aim of this study is to report the case of a patient with Fahrs Disease in order to describe the main stomatognathic and vocal changes that can be found in individuals with this disease. In order to establish the diagnosis, an assessment of the conditions of orofacial motor system and speech production, as well the efficiency of swallowing, was realized. Based on these assessments, there were difficulties in coordinating and sustaining muscle during speech and presence of oropharyngeal dysphagia. Speech disorders found in Fahrs disease manifest themselves in complex and cover various aspects of phonological knowledge and the diseases that affect the basal ganglia have similar frames of speech-language disorders of the stomatognathic system, being able to present a picture of dysarthria.

Masticatory Changes as a Result of Oral Disorders in Smokers

Introduction For chewing to occur properly, it is necessary that all oral structures are present and of normal standard. Objectives The aim of this study is to verify the presence of oral changes in smokers and the impact of the changes on masticatory function compared with individuals who never smoked. Methods Forty-eight subjects were evaluated, split into two study groups (24 subjects each) of current tobacco users and individuals who have never smoked. The variables halitosis, presence of lesions suggestive of caries and periodontal problems, number of teeth, classification of malocclusions according to angle, standard grinding food, chewing pattern, and speed of chewing were evaluated. Results There was no statistically significant difference in tooth loss between the groups, but the smokers had more losses manifesting malocclusion. Most smokers had halitosis and lesions suggestive of caries and periodontal problems; the halitosis was associated with the latter variable. Masticatory speed was also reduced significantly in these individuals compared with the control group when associated with occlusal alterations, in addition to grinding food with the tongue. No difference was observed regarding the chewing pattern. The presence of halitosis and periodontal problems were more common in those who smoke more than 20 years. Conclusion There is an association between smoking and dental changes, which cause increased masticatory changes.

Influência da percepção olfativa e gustativa na fase oral da deglutição de indivíduos tabagistas

PURPOSE To analyze the difference between nonsmokers and smokers on the changes in the perceptions of smell and taste and to verify the influence of these aspects in the emergence of compensatory movements during swallowing. METHODS To evaluate these aspects, capabilities of olfactory and gustatory recognition were observed, as well as the compensation swallowing. Twenty-four patients were evaluated in each study group aged from 18 years, grouped in a stratified way. The olfactory evaluation consisted in presenting seven essences and one of three options should be chosen. For the taste test, 16 flavors were offered in a non-sequential and decreasing way in amount of solute. Swallowing solid and liquid was evaluated, in which aspects of compensation perioral muscles were observed. RESULTS Worst performance in olfactory and gustatory tests among smokers (p≤0.01) was found. Through the results of χ2 and Fishers exact tests, it was found that the contraction of the mentalis muscle is less observed in non-smokers, and smokers have an average degree of statistically significant change compared to nonsmokers. Furthermore, through the Spearman correlation coefficient, it was found that the worsening in the sensory tests implies increased compensation during swallowing in smokers. CONCLUSION These data allowed us to verify that the sensory changes have influence on swallowing pattern, indicating that these changes are aspects that should be considered in the differential diagnosis of changes in swallowing.PURPOSE To identify the immediate effects of voiced vibration and vocal fry exercises on healthy subjects by means of acoustic parameters and high-speed kymography. METHODS Thirty healthy subjects (18 women and 12 men, aged from 19 to 45 years old) participated in this study. The voices were recorded at the range of 44.100 samples/second, before and after of the vocal exercises. We developed a computational routine to extract jitter and shimmer. High-speed kymography was generated from laryngeal images for the analysis of the phase times: closed (CPh), open (OPh), of closing (cPh) and of opening (oPh) and used the paired t-Student test and the Mann-Whitney test, with a significance level of 0.05. RESULTS After voiced vibrations, acoustic parameters showed reduced jitter for both genders (p=0.018 for men and p<0.01 for women) and reduced shimmer for female voices (p<0.01). There was a decrease in CPh (p=0.046) and cPh (p=0.026) and an increase in OPh (p=0.05) in female vocal folds. After vocal fry, we identified decreased jitter (p<0.01) in female voices and cPh (p=0.026) in male vocal folds. CONCLUSION We observed more positive immediate effects of the voiced vibrations, mainly in voice quality and vocal folds among females. Nevertheless, studies with larger male sample and investigation of the appropriate time of vocal fry are necessary to confirm the results of this search.

Medidas faciais em indivíduos adultos sem queixas orofaciais: compatibilidade entre medidas antropométricas e percepção facial

PURPOSE: to verify the compatibility between findings of facial measurements by caliper and perception of facial features made ​​subjectively by an experienced evaluator. METHODS: 24 female and 24 male subjects, paired for sex and age, without morphological and functional complaints of the stomatognathic system were evaluated. Aspects of symmetry between the middle and lower thirds, height and width of the face, and outer corner of the right and left eyes to the corners of the right and left respectively lip were evaluated. Each measurement was performed three times by a digital caliper to consider the average of these values, considering asymmetric comparisons with differences more than 4 millimeters. The width of the face was obtained through digital caliper fitted with extension 10 centimeters. The evaluation of the perception of facial features was performed by a blinded evaluator as to the digital caliper measurements that should point symmetries and asymmetries in these same evaluative aspects. RESULTS: through the agreement Kappa and Chi- square test, it was possible to verify proper compatibility between the assessments, demonstrating the reliability of the methods used. Furthermore, it was found that there is a relationship between symmetry thirds of the face and assignment of facial typology on the perceptual evaluation, observing symmetry in medium and short faces and absence of a decisive standard for long faces. CONCLUSION: the characterization of facial symmetry by a digital caliper has a good compatibility with the subjective perception of an experienced evaluator.

Association between Lung Function and Vocal Affections Arising from Tobacco Consumption

Introduction Smoking is a major risk factor for numerous diseases; it is necessary to analyze the impact that the habit can have on vocal health. Objectives To determine the influence of smoking on changes in vocal production and lung vital capacity compared with nonsmokers. Methods This cross-sectional study compared smokers and nonsmokers (24 subjects each). Each participant underwent a vocal and spirometric evaluation to measure vital lung capacity. Results The results showed a worsening in lung vital capacity and other parameters of voice in smokers compared with nonsmokers. Furthermore, the decreased pulmonary vital capacity affected the evaluated voice parameters, and decreased carrying capacity was closely related to smoking. The time and amount of consumption had a direct relationship with the vocal and maximum phonation time. Conclusions This study showed that smoking causes voice disorders due to lung weakness. Thus, voice changes are affected both directly by interference of smoking on vocal structures and indirectly by increased weakness, which impairs lung vocal production.