Leila Susana Finger

Medidas vocais acústicas de mulheres sem queixas de voz e com laringe normal

It is important to establish normal voice standards in order to help guide voice professionals. Aim: to describe acoustic voice measures of adult young women...

Aspectos fisiológicos e clínicos da técnica fonoterapêutica de fonação reversa

Reverse phonation is the voice production during inspiration, accomplished spontaneously in situations such as when a person sighs. AIM: to do a literature review, describing discoveries related to the use of the reverse phonation in the clinical practice, the anatomy and physiology of its production and its effects in vocal treatments; and moreover, indications and problems of the technique for speech disorders treatment and voice enhancement. RESULTS: there were reports of significant changes in vocal treatment during with the use of reverse phonation: ventricular distention, ventricular folds separation, increase in the fundamental frequency, mucous wave inverse movement; and it also facilitates the dynamic study of the larynx when associated with endoscopy, making it possible to have a better definition of lesion localization in vocal folds superficial lamina propria layers. CONCLUSION: There are few studies describing larynx behavior during reverse phonation and, for this technique to be used in a more precise and objective way, more studies are necessary in order to prove its effectiveness in practical matters.

Disfonias: relação S/Z e tipos de voz

PURPOSE: to check the result of s/z ratio and types of voice in patients with diagnosis of organic-functional dysphonias (DOF) and functional dysphonias by incorrect use of voice (DFUIV), as well as the occurrence of the various pathologies within the DOF. METHODS: 70 subjects of both genders, between 5 and 65 years old, seen in a clinic-school, registered in a data bank from 1998 to 2006, with DOF and DFUIV, both classified in three sub-groups: cases in which the s/z ratio indicated hypercontraction, normality and lack of coaptation of the vocal folds during phonation. According to the occurrence, the types of voice were classified in: without alteration; noisy; compressed and/or presenting alteration of f0h; noisy and/or with alteration of f0h; and compressed. RESULTS: significant presence of DOF and DOF with vocal nodules; in DOF and DFUIV, significant presence of the normal s/z ratio with isolated times of /s/ and /z/ below the normal and noisy voice. CONCLUSIONS: the result of the s/z ratio was statistically significant in favor of the range of established normalcy, both in patients with a diagnosis of DOF, as well as with those with DFUIV, and that, in both groups of patients, the noisy voice was the most frequent. Within the DOF, the vocal nodules were significantly more frequent than the other pathologies.

Modificações vocais acústicas produzidas pela fonação reversa

OBJETIVO: Descrever as modificacoes vocais acusticas e as sensacoes ocorridas apos a tecnica vocal de fonacao reversa em mulheres adultas jovens, sem queixas vocais e com laringe normal. METODOS: Trinta e duas mulheres adultas jovens submeteram-se a avaliacao otorrinolaringologica e triagem fonoaudiologica para descartar possiveis alteracoes que pudessem interferir nos resultados da pesquisa; tiveram amostras vocais coletadas antes e apos realizarem tres series de 15 repeticoes de fonacao reversa, em tempo maximo de fonacao com tom e intensidade habituais, e 30 segundos de repouso passivo entre cada serie. Apos, responderam a um questionario referente as sensacoes percebidas. A analise vocal acustica foi realizada atraves do software Praat (versao 4.6.10) e os dados analisados por meio da estatistica descritiva e pelo teste de Wilcoxon, com nivel de significância de 5%. RESULTADOS: Aumento estatisticamente significativo da frequencia fundamental e da frequencia maxima; diminuicao da frequencia minima; aumento das medidas de Jitter, exceto da medida de Jitter local-absoluto que diminuiu; diminuicao das medidas de Shimmer, relacao ruido/harmonico (NHR) e relacao harmonico/ruido (HNR); e predominio das sensacoes positivas. CONCLUSAO: A fonacao reversa pareceu promover efeito positivo sobre a vibracao da mucosa das pregas vocais e sobre o seu alongamento. Sugere efeito sobre a musculatura, favorecendo mudancas de frequencia fundamental; e sobre sua homogeneizacao e modificacao da camada de muco. Alem disso, promoveu melhora global do sinal vocal e das sensacoes durante sua producao.

Considerações sobre modificações vocais e laríngeas ocasionadas pelo som basal em mulheres sem queixa vocal

ABSTRACT The aim of this study was to verify vocal and laryngeal modifications caused by vocal fry in five female subjects without vocal or laryngeal complaints. For this purpose, the sustained emission of the vowel /a/ was digitally recorded, as well as the recording of a videostroboscopic examination of the larynx. Subsequently, the subjects performed the vocal fry in three series of 15 repetitions, with a 30-second interval of passive rest between series, and carried out a second evaluation (recording of the sustained emission of the vowel /a/ and the videostroboscopic examination of the larynx). Both laryngeal and vocal data found prior to and after the vocal fry technique were submitted to acoustic, auditory-perceptive, and videostroboscopic analyses. The acoustic analysis was generated by the Multi Speech program. Analyses showed the following effects of the vocal fry: increase of the vibration of the vocal folds mucosa; alteration or maintenance of voice type and pitch; decrease or maintenance of measures related to jitter and shimmer, as well as the index that suggests glottic noise; decrease of the soft phonation index; maintenance or alteration of the vocal quality and resonance focus, with laryngopharyngeal prevalence; decrease of the fundamental frequency; and increase of frequency and width variations. The study allowed the conclusion that vocal fry had a positive effect on the vibration of the vocal folds mucosa as well as on voice noise, and a negative effect on voice resonance and stability.

Modificações vocais acústicas espectrográficas produzidas pela fonação reversa

OBJETIVO: conhecer os efeitos da tecnica de fonacao reversa, realizando analise da sua eficacia sobre vozes femininas normais, por meio da espectrografia acustica de banda larga e de banda estreita. METODOS: 32 mulheres adultas jovens, que assinaram o Termo de Consentimento Livre e Esclarecido da pesquisa, submeteram-se a avaliacao otorrinolaringologica e triagem fonoaudiologica a fim de eliminar possiveis alteracoes que pudessem interferir nos resultados da pesquisa. Tiveram amostras vocais coletadas antes e apos realizar tres series de 15 repeticoes de fonacao reversa em tempo maximo de fonacao com tom e intensidade habituais, com 30 segundos de repouso passivo entre cada serie. Utilizou-se o software Real Time Spectrogram (Kay Elemetrics Corp.) para gerar espectrogramas de banda larga e de banda estreita. Os dados obtidos foram analisados por meio de porcentagem simples e do teste do Qui-Quadrado, com nivel de significância de 5%. RESULTADOS: houve tendencia percentual ao aumento da definicao de harmonicos, da regularidade do tracado, da intensidade e da definicao dos Formantes 3 e 4, da intensidade das altas frequencias e em todo o espectro; e aumento significante da definicao do Formante 1. CONCLUSAO: acredita-se que a tecnica favoreca o alongamento e a vibracao das pregas vocais com possivel homogeneizacao e modificacoes ocorridas na mucosa, e consequente melhoria do sinal vocal, com maior regularidade de vibracao e melhora de ressonância.

Reverse phonation--physiologic and clinical aspects of this speech voice therapy modality.

UNLABELLED Reverse phonation is the voice production during inspiration, accomplished spontaneously in situations such as when a person sighs. AIM to do a literature review, describing discoveries related to the use of the reverse phonation in the clinical practice, the anatomy and physiology of its production and its effects in vocal treatments; and moreover, indications and problems of the technique for speech disorders treatment and voice enhancement. RESULTS there were reports of significant changes in vocal treatment during with the use of reverse phonation: ventricular distention, ventricular folds separation, increase in the fundamental frequency, mucous wave inverse movement; and it also facilitates the dynamic study of the larynx when associated with endoscopy, making it possible to have a better definition of lesion localization in vocal folds superficial lamina propria layers. CONCLUSION There are few studies describing larynx behavior during reverse phonation and, for this technique to be used in a more precise and objective way, more studies are necessary in order to prove its effectiveness in practical matters.

Lesões organofuncionais do tipo nódulos, pólipos e edema de Reinke

TEMA: lesoes organofuncionais sao formacoes benignas decorrentes de comportamento vocal alterado e inadequado, sendo as mais comuns: nodulos, polipos vocais e edema de Reinke. OBJETIVO: realizar um estudo comparativo dos dados descritos na literatura sobre prega vocal normal e afeccoes organofuncionais do tipo nodulos, polipos e edema de Reinke. O estudo foi realizado por meio de um levantamento bibliografico em periodicos indexados no Science Direct, periodicos Capes, LILACS, SciELO, MedLine e Scopus e livros, no periodo de 1999 a 2010. CONCLUSAO: a distribuicao dos constituintes da matriz extracelular da lâmina propria lw32da mucosa, fibras elasticas, colagenas, acido hialuronico e fibronectina, encontra-se alterada nas tres afeccoes. Ocorre modificacao das caracteristicas vibratorias de amplitude, propagacao da onda de mucosa e simetria do padrao vibratorio devido a presenca do aumento de massa nas pregas vocais, ao contrario do que se observa nas pregas vocais sem afeccao. O sinal perceptivo-auditivo da qualidade vocal encontrado nas tres lesoes e a rouquidao, seguida da soprosidade e da aspereza (excecao do edema de Reinke), sinalizando a presenca de ruido acustico a emissao, estando presente tambem, no edema de Reinke, o agravamento consideravel da frequencia fundamental. Quanto a etiologia observou-se a predominância dos usos incorretos, e quanto a incidencia, nodulos e edema de Reinke predominam no sexo feminino e polipos no sexo masculino.

Influência da levodopa sobre a fase oral da deglutição em pacientes com Doença de Parkinson

The purpose of this study is to conduct a literature review in order to verify the possible influence of Levodopa on the oral phase of deglutition in individuals with Parkinson disease. The survey was conducted in journals indexed in Science Direct, Capes periodicals, LILACS, SciELO, MedLine and Scopus, as well as in books. For this survey, the terms disfagia/dysphagia/disfagia, medicamentos/drugs/las drogas, levodopa, Parkinson/Parkinson disease/ enfermedad de Parkinson and swallowing disorders were used. It was possible to identify 16 international and 25 national scientific articles. After reading every identified papers, 32 were selected in addiction to four books and one abstract published in scientific conference proceedings were used. For such selection, the inclusion criteria were the papers which considered the impairments caused by Parkinson´s disease, especially during the oral phase of swallowing, as well as the effects of levodopa about it. As exclusion criteria, the drug influence during pharyngeal phase was considered, because it usually seems to have higher effect during oral phase. There is disagreement in the literature surveyed considering Levodopa possible effects in deglutition. When these effects occur, they generally affect the oral phase of this function, since difficulties already present in Parkinson Disease carriers are maximized by the xerostomia due to the administration of this drug. Considering the vast range of results found in the studies surveyed, developing controlled studies for a detailed elucidation of Levodopa effects in deglutition becomes necessary.

Características vocais de gêmeos monozigóticos

BACKGROUND: vocal features of monozygotic twins and their relation with the normative data for unrelated peers. PROCEDURES: the sample was composed of two pairs of adult twins, one pair of each gender had undergone otorhinolaryngologic, auditive, vocal auditory perceptual and acoustic evaluations. Data was showed in a descriptive way and discussed comparatively with the normative data for unrelated peers on literature and on the applied program. The test t of Student (significance 5%) was used to test the differences between the average and the normative values. RESULTS: there were no differences related to voice onset, articulation, loudness, resonance, breathing type and mode in both evaluated monozygotic twin pairs, and they were adequate. There were signs of muscular hypertension related to vocal production in both pairs, the type of voice was considered slightly altered in both pairs and there was a difference regarding the twins Maximum Phonation Time. All the acoustic measurements were in accordance to the normative patterns of Multi Dimensional Vocal Program. CONCLUSION: the measurements found in this study seem to follow the trend of those described in studies that evaluated monozygotic twins.