Maria Cristina de Almeida Freitas Cardoso

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.

Feeding methods for children with cleft lip and/or palate: a systematic review.

INTRODUCTION Feeding difficulties in children with cleft lip and palate (CLP) are frequent and appear at birth due to impairment of sucking and swallowing functions. The use of appropriate feeding methods for the different types of cleft and the period of the childs life is of utmost importance for their full development. OBJECTIVE Review studies comparing feeding methods for children with CLP, pre- and postoperatively. METHODS The search covered the period between January 1990 and August 2015 in the PubMed, LILACS, SciELO, and Google Scholar databases using the terms: cleft lip or cleft palate and feeding methods or breastfeeding or swallowing disorders and their synonyms. This systematic review was recorded in PROSPERO under number CRD42014015011. Publications that compared feeding methods and published in Portuguese, English, and Spanish were included in the review. Studies with associated syndromes, orthopedic methods, or comparing surgical techniques were not included. RESULTS The three reviewed studies on the period prior to surgical repair showed better feeding performance with three different methods: squeezable bottle, syringe, and paladai bottle. Only one study addressed the postoperative period of cleft lip and/or palate repair, with positive results for the feeding method with suction. Likewise, the post-lip repair studies showed better results with suction methods. After palatoplasty, two studies showed better performance with alternative feeding routes, one study with suction method, and one study that compared methods with no suction showed better results with spoon. CONCLUSION The studies show that prior to surgical repair, the use of alternative methods can be beneficial. In the postoperative period following lip repair, methods with suction are more beneficial. However, in the postoperative period of palatoplasty, there are divergences of opinion regarding the most appropriate feeding methods.

Sintomas de disfagia em crianças com fissura labial e/ou palatina pré e pós-correção cirúrgica

PURPOSE Determine the occurrence of dysphagia symptoms in children with cleft lip and/or palate (CLP) pre- and post-surgical correction. METHODS Quantitative observational cross-sectional study. Existence of clef lip and/or palate without association with other syndromes was the study inclusion and/or exclusion criterion. Parents and/or legal guardians responded to a recall questionnaire on the identification of occurrence of coughing, choking, vomiting, and nasal escape pre- and postoperatively and whether these symptoms disappeared after surgical correction. The study was approved by the Research Ethics Committee of the aforementioned Institution under protocol no. 1573164. RESULTS The sample comprised 23 children with mean age of 48 months, mostly male and with unilateral trans-foramen incisor clefts. Statistically significant difference was observed between the pre- and post-surgical periods regarding the presence of dysphagia symptoms. CONCLUSION Surgical treatment of patients with cleft lip and/or palate proved to be a resource to prevent the occurrence of dysphagia symptoms when associated with adequate intervention chronology.

Speech-language pathology aspects in a pediatric case of head and neck arthrogryposis

Arthrogryposis is a rare, multiple, congenital syndrome of non-progressive nature characterized by a series of genetic malformations, as well as stiffness and joint contractures. This is a clinical case study whose objective is to describe speech-language pathology disorders through the evaluation process in a case of arthrogryposis in Pediatrics. The medical records of a patient were analyzed from birth. A complete clinical evaluation of pediatric dysphagia was performed, establishing a diagnosis of severe oropharyngeal dysphagia evidenced by functional and structural impairments. Hearing loss was detected in association with this condition.

Associação entre escalas de avaliação de funcionalidade e severidade da disfagia pós-acidente vascular cerebral

Objetivo O objetivo deste estudo foi verificar a associacao entre os resultados das escalas de funcionalidade e severidade da disfagia determinadas a partir de exames de videofluoroscopia em pacientes pos-AVC. Metodo Estudo observacional, retrospectivo e descritivo, com analise de 109 exames de Videofluoroscopia da Degluticao de pacientes pos-AVC. Dos exames da amostra foram coletadas informacoes quanto ao diagnostico da severidade da disfagia e avaliados quanto a funcionalidade da degluticao de maneira independente por dois avaliadores. Resultados Foi constatada uma alta prevalencia de disfagia classificada como discreta. Nos pacientes com disfagia foi observada a presenca de aspiracao laringotraqueal em um terco da amostra. Verificou-se associacao significativa entre os escores das escalas Functional Oral Intake Scale e Dysphagia Outcome and Severity Scale em pacientes pos-AVC, ou seja, quanto maior o comprometimento da degluticao, menor o nivel de ingestao por via oral na analise dos avaliadores (p < 0,001). Conclusao Ha associacao entre as escalas, podendo elas serem utilizadas como balizadores avaliativos e no gerenciamento da intervencao clinica fonoaudiologica.

Conduta fonoaudiológica em um caso de disfagia neurogênica por distrofia muscular oculofaríngea

The Muscular Dystrophy Oculo-pharyngeal myopathology is a hereditary autosomal dominant, late-onset, with clinical signs of ptosis and oral pharyngeal dysphagia, this may be associated to the proximal muscle weakness. This study examines the speech therapy conduct in a case of oculus-pharyngeal dystrophy. The subject was treated in the speech-language therapy outpatient since March 2013, with biweekly sessions, being changed to weekly sessions from July of the same year. The therapy consists of improving mobility of oral facial structures; organization of the pneumonic articulatory coordination; frequent revaluations of the swallowing disorders, with the register of the episodes of signals and symptoms of swallowing disorders in the habitual feeding, as well as, by the verification of the usual diet consistencies with security maneuver (chin-chest); weight check; using the habitual daily swallowing disorders diary, and orientation for the accomplishment of the daily oral facials exercises at home. She had stabilization of the clinical picture and the corporal weight during the year of attendance, with posterior retaken of disease progression. The suggested clinical aiming is of interdisciplinary boarding, having as contribution from speech and language therapy, the aiding of a safe feeding, the facilitation of the verbal communication and improvement of the quality of life.