Maria Inês Beltrati Cornacchioni Rehder

Avaliação miofuncional orofacial: protocolo MBGR

PURPOSE: to present a protocol with scores on the Orofacial Myofunctional area. This protocol is called MBGR. METHODS: based on different protocols used in the Orofacial Myofunctional area, a new protocol with scores was elaborated. This protocol was applied in both, patients and non-patients during five distinct phases during the elaboration. After each phase, the results were analysed and the necessary corrections were performed in order to improve the protocol and, in this way, provide an accurate diagnosis and prognosis. It took two years to elaborate the protocol. During those two years, independent judges were responsible for testing the protocol in each phase. RESULTS: a new protocol with scores on the Orofacial Myofunctional area was elaborated and tested during two years in different phases. The new MBGR Protocol gives the possibility to obtain numeric parameters. CONCLUSION: the MBGR Protocol with scores was presented. This protocol helps the Speech-Language Pathologist to evaluate and give the diagnosis and the prognosis on the Orofacial Myology area.

Correlações entre alterações de fala, respiração oral, dentição e oclusão

OBJETIVO: verificar as correlacoes entre alteracoes de fala e sinais de respiracao oral ao tipo de denticao e oclusao, utilizando-se registros em video. METODOS: estudo retrospectivo, de 397 pacientes, por meio de levantamento do roteiro de filmagem ROF. Tipos de alteracoes de fala e de sinais de respiracao oral foram avaliados por Fonoaudiologos Especialistas em Motricidade Orofacial e comparados com os tipos oclusais propostos por Angle e com parâmetros da denticao, ambos avaliados por Ortodontista. Para a analise estatistica foi utilizado o programa SPSS (Statistical Package for Social Sciences), em sua versao 13.0. Para a analise de correlacao de Spearman, todos os dados da avaliacao foram pareados e analisados. Foi adotado o nivel de significância de 5%. RESULTADOS: Considerando alteracoes de fala e dados de denticao e oclusao, observou-se paralelismo entre distorcao e mordida cruzada, imprecisao e desvio osseo de linha media inferior, travamento e sobressaliencia, travamento e sobremordida, ceceio anterior e Classe III de Angle, ceceio anterior e mordida aberta, ceceio anterior e mordida cruzada; e ceceio anterior e desvio de linha media inferior. Observou-se ainda correlacao de oposicao entre travamento e mordida aberta, travamento e desvio osseo de linha media inferior, ceceio anterior e Classe II-1 de Angle, ceceio anterior e sobressaliencia; e ceceio anterior e sobremordida. Considerando os sinais de respiracao oral e dados de denticao e oclusao, observou-se sinal de paralelismo entre eversao de labio inferior e sobressaliencia, acumulo de saliva nas comissuras labiais e mordida cruzada, acumulo de saliva nas comissuras labiais e falta de espaco intra-oral; e labios entreabertos no repouso e Classe II-1 de Angle. Olheira e classe II-1 de Angle, eversao de labio inferior e Classe II-1 de Angle; e labio superior encurtado e sobremordida apresentaram correlacao de oposicao. CONCLUSOES: o ceceio anterior esta correlacionado a alteracoes de denticao e a Classe III de Angle; olheira, eversao do labio inferior e labios entreabertos no repouso sao adaptacoes presentes na Classe II-1, nao caracterizando respiracao oral neste grupo; o acumulo de saliva nas comissuras labiais foi o sinal de respiracao oral que se correlacionou as alteracoes de denticao.

Análise vocal perceptivo-auditiva e acústica, falada e cantada de regentes de coral

BACKGROUNDnthe voice of choir conductors.nnnAIMnto evaluate the vocal quality of choir conductors based on the production of a sustained vowel during singing and when speaking in order to observe auditory and acoustic differences.nnnMETHODnparticipants of this study were 100 choir conductors, with an equal distribution between genders. Participants were asked to produce the sustained vowel é using a singing and speaking voice. Speech samples were analyzed based on auditory-perceptive and acoustic parameters. The auditory-perceptive analysis was carried out by two speech-language pathologist, specialists in this field of knowledge. The acoustic analysis was carried out with the support of the computer software Doctor Speech (Tiger Electronics, SRD, USA, version 4.0), using the Real Analysis module.nnnRESULTSnthe auditory-perceptive analysis of the vocal quality indicated that most conductors have adapted voices, presenting more alterations in their speaking voice. The acoustic analysis indicated different values between genders and between the different production modalities. The fundamental frequency was higher in the singing voice, as well as the values for the first formant; the second formant presented lower values in the singing voice, with statistically significant results only for women.nnnCONCLUSIONnthe voice of choir conductors is adapted, presenting fewer deviations in the singing voice when compared to the speaking voice. Productions differ based the voice modality, singing or speaking.

Valor e variações da freqüência fundamental no choro de dor de recém-nascidos

PURPOSE: to study the value of fundamental frequency and its variations found in newborn pain cry. METHODS: emissions of 111 healthy and term newborns were recorded, whose lifetime varied from 24 to 72 hours, during venepuncture procedures. The acoustic analysis was realized with VOXMETRIA 1.1 software, with an extract from the fundamental frequency value and GRAM 5.7, in order to verify the occurrence of fundamental frequency variations such as breaks, double harmonic breaks and higher fundamental frequency. The NIPS scale was carried out during venepuncture. The statistical analysis is descriptive with extract from the mean values, standard deviation and frequency of event occurrence. RESULTS: the newborns showed 100% of their emissions with frequency variations, in other words, breaks and double harmonic breaks. The higher fundamental frequency was found in 34.2% of the newborns. CONCLUSION: the newborn communicates pain through cry. The newborn pain emission is tense and strident with higher fundamental frequency and variations founds at the spectrographic tracing such as breaks, double harmonic breaks and higher fundamental frequency. Such characteristics are important to attract adult attention concerning as for a fast support to the newborns and to help in the evaluation of pain during a procedure.

Perfil vocal de regentes de coral do estado de São Paulo

OBJETIVO: tracar o perfil vocal de regentes de corais do Estado de Sao Paulo. METODOS: participaram deste estudo 150 regentes de corais do Estado de Sao Paulo. A coleta foi feita individualmente pelo mesmo avaliador, nos locais de trabalho dos entrevistados, atraves de questionario fechado. RESULTADOS: os regentes tem em media 8,4 anos de exercicio da profissao, regem 1 coral e ja fizeram de 1 a 5 anos de aula de canto. Ensaiam os naipes em separado, cantam junto com os naipes, fazem aquecimento e nao fazem desaquecimento vocal. Para a afinacao do coral, usam piano e/ou a propria voz. A maior parte considera a voz falada igual a cantada e ambas eficientes, ha concordância no que se refere ao dom e a tecnica como componentes necessarios a uma boa voz cantada. Com os anos de exercicio de regencia, a tessitura vocal esta mais ampla, a qualidade mais estavel, a passagem mais controlada e a intensidade no pianissimo e no fortissimo permaneceram inalteradas. As queixas vocais mais apontadas foram: pigarro, rouquidao, garganta seca, acumulo de secrecao na garganta, cansaco apos fala, cansaco apos canto e tensao na garganta. A maior parte dos regentes apresenta ate 3 sintomas vocais, nao fumam, nao bebem, nao costumam gritar, nao pigarreiam, falam muito e comem tarde da noite. CONCLUSAO: houve associacao de sintomas vocais com piora e/ou restricao de diversos parâmetros especificos da voz cantada. O parâmetro que mais se alterou frente aos sintomas vocais foi a qualidade vocal.

Frênulo lingual: classificação e conduta segundo ótica fonoaudiológica, odontológica e otorrinolaringológica

PURPOSE: to compare the classification and conduct of the professionals of speech language pathology, dentistry and otolaryngology fields regarding the lingual frenulum. METHODS: 90 participants took part in this research, divided into 3 groups: 30 speech language pathologists, 30 dentists and 30 otolaryngologists who answered two protocols, with 4 images of the lingual frenulum. The lingual frenulum was classified as normal or altered. When the option was altered, the indicated conduct was: surgery, speech therapy or surgery and speech therapy. The participants also classified the frenulum according to the type of insertion: normal, with anterior insertion, short or short with anterior insertion. RESULTS: in relation to the characterization of the lingual frenulum as normal or altered, we found that most professionals had similar views, characterizing the normal frenulum as normal, and the anterior, the short one and short with anterior insertion as altered. In relation to the conduct of the altered lingual frenulum, the majority of dentists and otolaryngologists agreed about the surgical conduct for all altered frenulum. For the majority of speech language pathologists, the conduct for anterior lingual frenulum was speech therapy, and for the short lingual frenulum and short with anterior insertion, they indicated surgery followed by speech therapy. For the classification according to the type of insertion, the opinion of the majority of the three professional categories was the same. CONCLUSION: the findings showed agreement in characterization and classification of the lingual frenulum by professionals of the three areas. There was disagreement in relation to the conduct: surgery and speech therapy or only surgery for short frenulum and short with anterior insertion.

Coincidências e divergências entre transcrição e textualização de áudios

OBJETIVO: investigar coincidencias e divergencias entre transcricao e textualizacao de audios, a fim de verificar se ha evidencias estatisticas que possam servir de subsidio quanto ao melhor procedimento a ser aplicado. METODOS: estudo retrospectivo. Foram selecionados aleatoriamente 30 audios, entre os 239 audios disponiveis, provenientes de interceptacoes telefonicas do mesmo processo judicial. Foram considerados: o numero de palavras e tempo em minutos para a realizacao de cada audio, e a analise comparativa da manutencao dos focos principais de conteudo. Tres Fonoaudiologos transcreveram e textualizaram tercos diferentes do arquivo, garantindo independencia. Um Fonoaudiologo, que nao participou da etapa anterior, realizou a analise de conteudo. Para a analise estatistica foi utilizado o teste de Wilcoxon-Mann Whitney no ambiente R, com interface Tinn R. Nivel de significância de 5% (0,05). CEP: 274-742. RESULTADOS: o numero medio de palavras utilizadas na transcricao dos arquivos de audio foi 27% maior que o numero de palavras utilizadas na textualizacao, p=0,52. A media do tempo em minutos necessarios para realizar a transcricao foi significantemente maior p=0,013. Na analise comparativa da manutencao dos focos principais de conteudo, foi possivel verificar que em media 93% dos focos foram mantidos, p=0,61%. CONCLUSAO: as semelhancas entre os processos de transcricao e textualizacao foram com relacao ao numero mediano de palavras e a manutencao do numero mediano de focos de conteudo. Houve divergencia quanto ao tempo para a realizacao, significantemente menor na textualizacao. Considerando os dados obtidos neste estudo, o processo de textualizacao mostrou ser o mais indicado na degravacao de audios.

Relação entre a desnutrição infantil e a antropometria orofacial

PURPOSES: to describe the anthropometric orofacial measurements according to age and gender; to compare the average of the left side of the face to the average of the right side of the face, according to age and gender. METHODS: 27 afro-descending children bearers of malnutrition with ages ranging from 4 to 6 years. RESULTS: there was no statistical difference for the anthropometric orofacial measurements according to age and gender. For inferior lip, philtrum and the left side of the face, the measurements presented themselves in a bigger proportion in males. There was no significant difference between the right and the left side, regarding the distance between the external corner of the eye and the cheilion, according to age and gender. CONCLUSION: the age did not represent signification in the results, but there were differences to gender. There were no statistical differences in the comparison of the measurements between the sides of the face for age or gender.