Navegando por Palavras-chave "Voice disorders"

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    A autopercepção da voz do adolescente
    (Sociedade Brasileira de Fonoaudiologia, 2009-01-01) Almeida, Anna Alice Figueirêdo de [UNIFESP]; Behlau, Mara [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Paraíba; Centro de Estudos da Voz
    PURPOSE: To verify the self-perception of adolescents concerning their own voice. METHODS: A questionnaire regarding voice and communication was applied to 80 volunteer adolescents, 58 female (72.5%) and 22 male (27.5%), with ages ranging from 10 to 19 years, participants of the Program of Adolescent Healthcare of the State of São Paulo. Subjects answered the questionnaire themselves, and data were statistically analyzed. RESULTS: The main age range was from 16 to 17 years (23 - 28.8%). Half of the subjects (41 - 51.3%) reported positive vocal characteristics, classifying it as normal (42 - 52.5%); in addition, 33 (41.3%) did not detect vocal modifications during adolescence, demonstrating satisfaction with their production (65 - 81.3%), referring that their voices matched their personality (27 - 33.8%) and, therefore, they did not wish to modify it (61 - 76,3%). The three most frequently reported negative vocal habits were: yelling (30 - 37.5%), drinking cold beverages (20 - 32.5%), and smoking (22 - 27.5%). In turn, the subjects reported as beneficial vocal habits: drinking water (31 - 38.8%), singing (30 - 37.5%) and not yelling (20 - 25%). Young men reported vocal problems related to pitch (54.5%, p<0.001), and young women, to loudness (32.1%, p<0.001). These problems were pointed out as impairing factors to their communication. CONCLUSION: The perception of adolescents about their voice and communication interferes in their relationship with others, in their way of thinking and acting, and the way they interact with reality and the society.
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    Comparação entre as análises auditiva e acústica nas disartrias
    (Sociedade Brasileira de Fonoaudiologia, 2008-01-01) Ortiz, Karin Zazo [UNIFESP]; Carrillo, Luciane; Universidade Federal de São Paulo (UNIFESP); Centro de Estudos da Voz; San Jose State University Communication Studies Department
    PURPOSE: To compare data found in auditory-perceptual analyses (subjective) and acoustic analyses (objective) in dysarthric patients. METHODS: Forty-two patients with well defined neurological diagnosis, 21 male and 21 female, were evaluated in auditory-perceptual parameters and acoustic measures. All patients had their voices recorded. Auditory-perceptual voice analyses were made considering type of voice, resonance (balanced, hipernasal or laryngopharyngeal), loudness (adequate, decreased or increased), pitch (adequate, low or high), vocal attack (isochronic, sudden or breathy), and voice stability (stable or unstable). Acoustic analyses were made with GRAM 5.1.7 Program that considered voice quality and spectrographic tracing, and Vox Metria Program to obtain objective measures. RESULTS: The comparison between auditory-perceptual and acoustic data showed no correlation for all the parameters analyzed. It was found a significant difference between breathiness and shimmer alteration (p=0.048), and between breathiness and harmonics definition (p=0.040), evidencing correlation between noise presence during emission and breathiness. CONCLUSION: Acoustic analysis associated to auditory-perceptual analysis provided different but complementary data, helping the clinical diagnosis of dysarthias.
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    Comportamento vocal de teleoperadores pré e pós-jornada de trabalho
    (Sociedade Brasileira de Fonoaudiologia, 2011-01-01) Amorim, Geová Oliveira de [UNIFESP]; Bommarito, Silvana [UNIFESP]; Kanashiro, Célia Akemi; Chiari, Brasilia Maria [UNIFESP]; Universidade Estadual de Ciências da Saúde de Alagoas; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To evaluate the vocal behavior of receptive telemarketing operators in pre- and post-work shift moments, and to relate the results to the variable gender. METHODS: Participants were 55 telemarketing operators (11 men and 44 women) working in a receptive mode in the city of Maceió (Alagoas, Brazil). A questionnaire was applied before the work shift to initially identify the vocal complaints. After that, vocal samples were recorded, comprising sustained emissions and connected speech produced 10 minutes before and 10 minutes after the workday to be later evaluated. Auditory-perceptual and acoustic analyses of voice were conducted. RESULTS: Vocal complaints and symptoms reported by the operators after the work shift were: dry throat (64%); neck and cervix pain (33%); hoarseness (31%); voice failure (26%); and vocal fatigue (22%).Telemarketing operators presented reduced maximum phonation time before and after the day of work (p=0.645). Data from the auditory-perceptual assessment of voice were similar in pre- and post-shift moments (p=0.645). No difference was found between moments also on acoustic analysis data (p=0.738). CONCLUSION: Telemarketing operators have high indexes of vocal symptoms after the work shift, and there are no differences between pre- and post-work shift in auditory-perceptual and acoustic assessments of voice.
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    Coping Strategies in Voice Disorders of a Brazilian Population
    (Elsevier B.V., 2012-03-01) Oliveira, Gisele [UNIFESP]; Hirani, Shashivadan P.; Epstein, Ruth; Yazigi, Latife [UNIFESP]; Behlau, Mara [UNIFESP]; CEV Ctr Estudos Voz; Universidade Federal de São Paulo (UNIFESP); UCL; City Univ London
    The purpose of this research is to explore coping strategies of individuals with and without vocal complaint and to examine relationships between the type of coping and vocal complaint; vocal symptoms; vocal self-assessment; perceptual analysis and states of depression, anxiety, and aspects related to self-esteem; and locus of control. One hundred seventy-eight subjects with (n = 87) and without vocal (n = 91) complaint completed the following analysis: identification and characterization questionnaire, vocal self-assessment, perceptual analysis, Voice Disability Coping Questionnaire (VDCQ)-Brazilian Version, Beck Depression Inventory, Rosenberg Self-esteem Scale, Spielberger State-Trait Anxiety Inventory, and Health Locus of Control Scale. Age (P = 0.219) and sex (P = 0.132) were similar for both groups. the groups were statistically different for the following vocal characterization: number of symptoms, voice complaint, vocal self-assessment, and perceptual analysis. Conversely, the groups did not differ on states of depression, anxiety, and aspects related to self-esteem; and locus of control. Mean coping scores for the group with vocal complaint was 51.86 and for the group without vocal complaint was 23.18. Furthermore, men and women did not differ on the coping strategies reported (P = 0.750); however, individuals with vocal complaint reported statistically more strategies than the individuals without vocal complaint (P < 0.001). Problem-focused strategies were more frequently reported by individuals with vocal complaint (46.7%). Coping results correlated (Spearman's r) positively with vocal perceptual analysis (P = 0.036), depression (P = 0.006), and anxiety (P = 0.022), and correlated negatively with locus of control (P = 0.001). No correlation was found between coping and the other variables studied. These findings indicate that people with vocal complaint use a variety of coping strategies, problem focused in particular, to deal with their voice problems. Coping results appear to be associated with perceptual characteristics of voice and some traits, such as depression, anxiety, and locus of control.
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    Cross-Cultural Adaptation, Validation, and Cutoff Values of the Brazilian Version of the Voice Symptom Scale-VoiSS
    (Elsevier B.V., 2014-07-01) Moreti, Felipe [UNIFESP]; Zambon, Fabiana [UNIFESP]; Oliveira, Gisele; Behlau, Mara [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); CEV
    Objectives. the present study sought to determine the validity, reliability, and responsiveness of the Brazilian Portuguese Voice Symptom Scale (VoiSS) and also identify characteristics of efficacy and cutoff values that discriminate dysphonic from vocally healthy individuals.Study Design. Cross-sectional, nonrandomized, prospective study with controls.Methods. Thirty hundred subjects (160 with dysphonia and 140 without dysphonia) completed the Brazilian version of the VoiSS as well as a vocal self-assessment scale using a five-point rating system (excellent, very good, good, fair, and poor).Results. the Brazilian version of VoiSS, referred to as the Escala de Sintomas Vocais (ESV), was valid, reliable, and responsive. A score of 16 was determined to be highly sensitive (100%) and specific (100%) for individuals with dysphonia.Conclusions. the Brazilian version of VoiSS or ESV demonstrated a high degree of validity, reliability, and responsiveness with regard to differentiating aberrant vocal function and was valuable as an instrument to quantify the response to treatment in patients with dysphonia. the cutoff value that discriminates individuals with dysphonia from vocally healthy subjects was 16.
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    Diagrama de desvio fonatório na clínica vocal
    (Universidade Federal de São Paulo (UNIFESP), 2009-02-18) Madazio, Glaucya [UNIFESP]; Behlau, Mara [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To identify which characteristics discriminates the hoarseness diagram of adult voices that are predominantly adapted, rough, breathy and strained. Method: 196 adult voice samples of the sustained vowel “ae” were analyzed. They were distributed into two groups, 163 with vocal deviation and 33 with healthy voices. Voice samples were submitted to two types of analyses: acoustic and auditory perceptual. The perceptual analyses focused on the identification of the vocal quality predominance – adapted, rough, breathy and strained and also in the degree of deviation, by using a visual analogue scale and its numeric correspondence. The acoustic analyses was performed by means of the VoxMetria software (CTS Informatica) and consisted of assessing the configuration of vocal sample distribution in the hoarseness diagram according to normality area, density, shape and location in the quadrants, and the extraction of fundamental frequency, jitter, shimmer, correlation and GNE. Results: There was a significant difference in the position of the voice samples in relation to the normality area of the diagram, meaning that 100% (33) of the adapted voices were located inside this area and 69.3% (113) of the deviated voices were outside it (p<0.001). Adapted voices presented concentrated density (78.8%, 26), which were statistically different from the deviated voices (56.4%, 92) that presented spread density (56.4%, 92). As far as voice type is concerned, all adapted voices were located at the inferior left quadrant, 45% (27) of the rough voices were at the inferior right, 52.6% (30) of the breathy voices were at the superior right and 54.3% (25) of the strained were at the inferior left. Concerning the degree of severity of vocal deviation, 93.8% of the 16 deviated voices evaluated as having a 1 degree of deviation were located at the inferior and superior right quadrants. In the other hand, 80 % (8) of the voice with a severe degree of deviation were located in the superior right quadrant. The inferior left quadrant concentrated the voices evaluated by the visual analogue scale up to 35.5mm (degree 1) and some from 35.5 to 50.5mm (degree 2). Voices with 3 degree of deviation were located in the inferior right Abstract and both superior left and right quadrants. The voices with the worse degree of deviation were located at the superior right quadrant. Jitter and shimmer differed the strained voices from the rough voices (p<0.021 e p=0.0032 respectively) and from the breathy voices (p=0.021 e p=0.005, respectively). The GNE did also differ the strained voices from the rough voices (p=0.003) and from the breathy voices (p<0.002).It also differentiated the rough from the breathy voices (p<0.001). The correlation between F0 and the other acoustic parameters was not significant and the quality of correlation was very poor: jitter (p=0.257; -8.9%), shimmer (p=0.158; -11.2%), correlation (p=0.285; 8.4%) and GNE (p=0.790; -2.1%). Conclusions: The hoarseness diagram differentiated the adapted from the deviated voices. Adapted voices were located in the normality area, and the majority of the deviated voices were outside it. There was not a relationship between type of voice, density and shape of configuration of vocal sample distribution in the diagram. The distribution of voices in the quadrants related to the type and degree of severity of voice deviation. GNE was the only acoustic parameter able to differ from the three types of deviated voices.
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    Distúrbios da voz em docentes: revisão crítica da literatura sobre a prática da vigilância em saúde do trabalhador
    (Sociedade Brasileira de Fonoaudiologia, 2012-01-01) Santana, Maria da Conceição Carneiro Pessoa de; Goulart, Bárbara Niegia Garcia de; Chiari, Brasilia Maria [UNIFESP]; Universidade Estadual de Ciências da Saúde de Alagoas Residência Multiprofissional em Saúde da Família; Universidade Estadual de Ciências da Saúde de Alagoas Departamento de Psicologia Social e Institucional; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To analyze scientific bibliographic production on the practice of occupational health surveillance related to voice disorders in teachers. Search STRATEGY: The Cochrane Handbook precepts which involves the formulation of the question to be investigated, the location, the studies selection and articles' critical evaluation were followed. SELECTION CRITERIA: The articles published between 2000 and 2011 were selected in the PubMed, LILACS, MEDLINE database, and the Cochrane Library using the descriptors voice disorders; teachers, occupational health, workers' health surveillance. DATA ANALYSIS: Texts were analyzed, using a standardized form when the following data were collected: objectives, research design, characteristics of the study group, obtained results and discussion on the practice of surveillance related to voice disorder. RESULTS: Initially, 141 studies were identified. After reviewing the titles and abstracts, considering inclusion and exclusion criteria, verifying consistency with the topic researched and eliminating the ones which were concurrently in more than one database, 32 articles were effectively analyzed for relating in the findings and/or conclusions to the practice of surveillance related to voice disorders in teachers. CONCLUSION: The practice of monitoring workers' health was evidenced in this research mainly as the identification of risk factors associated with voice disorders in teachers, aimed at the transformation of the working conditions and the assurance of quality of assistance to these workers as professionals.
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    The Effectiveness of the Comprehensive Voice Rehabilitation Program Compared With the Vocal Function Exercises Method in Behavioral Dysphonia: A Randomized Clinical Trial
    (Mosby-Elsevier, 2016) Pedrosa, Vanessa [UNIFESP]; Pontes, Antonio [UNIFESP]; Pontes, Paulo [UNIFESP]; Behlau, Mara [UNIFESP]; Peccin, Maria Stella [UNIFESP]
    Objective. To evaluate the effectiveness of the Comprehensive Voice Rehabilitation Program (CVRP) compared with Vocal Function Exercises (VFEs) to treat functional dysphonia. Study Design. This is a randomized blinded clinical trial. Methods. Eighty voice professionals presented with voice complaints for more than 6 months with a functional dysphonia diagnosis. Subjects were randomized into two voice treatment groups: CVRP and VFE. The rehabilitation program consisted of six voice treatment sessions and three assessment sessions performed before, immediately after, and 1 month after treatment. The outcome measures were self-assessment protocols (Voice-Related Quality of Life [V-RQOL] and Voice Handicap Index [VHI]), perceptual evaluation of vocal quality, and a visual examination of the larynx, both blinded. Results. The randomization process produced comparable groups in terms of age, gender, signs, and symptoms. Both groups had positive outcome measures. The CVRP effect size was 1.09 for the V-RQOL, 1.17 for the VHI, 0.79 for vocal perceptual evaluation, and 1.01 for larynx visual examination. The VFE effect size was 0.86 for the V-RQOL, 0.62 for the VHI, 0.48 for the vocal perceptual evaluation, and 0.51 for larynx visual examination. Only 10% of the patients were lost over the study. Conclusions. Both treatment programs were effective. The probability of a patient improving because of the CVRP treatment was similar to that of the VFE treatment.
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    Ensurdecimento de fonemas plosivos na fala de crianças disfônicas
    (Sociedade Brasileira de Fonoaudiologia, 2008-03-01) Arnaut, Mirian Aratangy [UNIFESP]; Ávila, Clara Regina Brandão de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To characterize the occurrence of plosive sounds' devoicing in the speech of dysphonic children. METHODS: Fifty children with ages between four and eight years old (40 dysphonic and ten without any vocal disorders) were recorded repeating six sentences containing plosive phonemes in initial, medial and final tonic positions. Both spectrographic and auditory-perceptual analyses were carried out. RESULTS: Devoicing of plosive phonemes occurred unsystematically. It was more identified in the spectrographic analysis, and varied according to the phoneme and its position in the word. CONCLUSION: The speech of both dysphonic children and children without vocal disorders presented unsystematic substitution of voiced by voiceless plosive phonemes. The substitutions were less frequent when the phoneme occurred in medial tonic position.
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    Equivalência cultural da versão Brasileira da Voice Symptom Scale: VoiSS
    (Sociedade Brasileira de Fonoaudiologia, 2011-12-01) Moreti, Felipe Thiago Gomes [UNIFESP]; Zambon, Fabiana [UNIFESP]; Oliveira, Gisele [UNIFESP]; Behlau, Mara [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Centro de Estudos da Voz
    PURPOSE: To present the cultural equivalence of the Brazilian version of the Voice Symptom Scale - VoiSS. METHODS: The questionnaire was translated into Portuguese by two Brazilian bilingual speech-language pathologists, who were informed about the purpose of this research. The back translation was performed by a third bilingual Brazilian speech-language pathologist, who was also an English teacher, and had not participated in the previous stage. After the comparison of translations, a final version of the questionnaire was produced and called Escala de Sintomas Vocais - ESV, which was administered to 15 individuals with vocal complaint. The inclusion criterion was the presence of dysphonia, regardless of type or degree. The option not applicable was added to each item of the protocol. RESULTS: During the process of translation and cultural adaptation, no item was changed and/or eliminated from the questions. The ESV kept the same structure as the original British version with 30 questions, 15 regarding the impairment domain (functionality), eight the emotional domain (psychological effect), and seven the physical domain (organic symptoms). CONCLUSION: The cultural equivalence of the Brazilian version of the VoiSS, entitled ESV, was demonstrated. The ESV validation is currently being concluded.
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    Escala URICA-VOZ para identificação de estágios de adesão ao tratamento de voz
    (Sociedade Brasileira de Fonoaudiologia, 2013-01-01) Teixeira, Letícia Caldas; Rodrigues, Ana Luíza Vilar; Silva, Áudrea Fernanda Girundi Da; Azevedo, Renata [UNIFESP]; Gama, Ana Cristina Cortes [UNIFESP]; Behlau, Mara [UNIFESP]; Universidade Federal de Minas Gerais Faculdade de Medicina Departamento de Fonoaudiologia; Universidade Federal de Minas Gerais Curso de Fonoaudiologia; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To adapt the URICA questionnaire to assess the motivational stages of patients undergoing voice treatment, and to determine the association between these stages with age, type of dysphonia, level of education, profession, and number of voice therapy sessions. METHODS: A cross-sectional study design was employed, using a convenience sample composed of 66 dysphonic patients - 58 women and eight men - aged from 18 to 68 years, who were enrolled in outpatient care at two federal universities. As an exploratory tool, the URICA questionnaire was adapted to the area of voice, based on specific situations related to vocal behaviors. This questionnaire was named URICA-VOICE. It was administered individually and subjected to analyses. RESULTS: Most patients, 38 (57.6%), were in the contemplation stage, 20 (30.3%) were in the pre-contemplation, and only eight (12.1%) in the action stage, which is ideal to voice therapy. There was no association between adherence stages and the variables age, type of dysphonia, level of education, and number of voice therapy sessions. The variable profession was associated with the action stage of the URICA-VOICE. CONCLUSION: The URICA-VOICE showed that most dysphonic patients undergoing treatment are still in the contemplation stage, which may limit therapy outcomes. There was no relationship between the other variables and the adherence stages of the URICA-VOICE questionnaire.
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    Factors associated with voice disorders among teachers: a case-control study
    (Sociedade Brasileira de Fonoaudiologia, 2013-12-01) Giannini, Susana Pimentel Pinto; Latorre, Maria Do Rosário Dias De Oliveira; Ferreira, Léslie Piccolotto; Pontifícia Universidade Católica de São Paulo; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    Purpose: We aimed at verifying an association between voice disorders/stress and loss of work ability among female teachers who work in São Paulo's public school system. Methods: This is a paired case– control study. The case group was composed offiteachers with alterations in speech and larynges assessments, and the control group was formed by teachers without alterations in these evaluations who work in the same schools. Both groups answered the following questionnaires: Conditions of Vocal Production—Teachers, Job Stress Scale, and Work Ability Index. The analysis was performed using the chi-square association test and logistic regression models with the purpose of estimating the association between independent variables and voice disorders. Results: We found differences between the groups in relation to stress in the workplace under high demand, a situation that poses greater risks of adverse reactions to the workers' physical and mental health. Regarding the ability to work, the categories poor and moderate ability for work are associated with voice disorders, regardless of job stress factors, age, and the unsatisfactory acoustic properties of the classrooms. Conclusion: This study confirmed the association between voice disorders and job stress, as well as between voice disorders and loss of work ability.
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    Intervenção fonoaudiológica em grupo a cantores populares: estudo prospectivo controlado
    (Sociedade Brasileira de Fonoaudiologia, 2012-01-01) Goulart, Bárbara Niegia Garcia De; Rocha, Jaqueline Garcia Da; Chiari, Brasilia Maria [UNIFESP]; Universidade Federal do Rio Grande do Sul; Universidade Feevale; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To assess the benefits of a group vocal improvement program to popular singers without voice disorders. METHODS: This is a quasi-experimental intervention study, carried out with 37 popular singers of both genders, with ages between 18 and 40 years and adapted vocal quality. Participants were divided into two groups: Intervention (IG) and Control (CG). The IG included 21 subjects who participated in seven weekly lectures regarding anatomy and physiology of the vocal tract, vocal hygiene care, and vocal exercises for voice improvement. The CG included 16 participants, who maintained their normal activities during this period, and did not receive any orientations regarding vocal improvement. In pre- and post-intervention, all participants answered a questionnaire about habits and demands related to the voice, and were evaluated regarding resonance, speech articulation, voice projection, pitch, loudness, maximum phonation time, and s/z ratio. RESULTS: The vocal training was positive in the perception of the singers, who reported improvement in their voices. The assessment of maximum phonation time and s/z ratio did not present differences between groups (p=0.57). No modifications of behaviors potentially harmful to the vocal health were observed within 60 days after the intervention (p=0.24). There was also no considerable decrease of voice complaints (p=0.1), although the decrease percentage of complaints in the IG (22.2%) was higher than that of the CG (11.1%). CONCLUSION: Group vocal training intervention in popular singers is positive regarding the perception of the individual about his/her voice production, even though they presented adapted voice from the beginning of the process.
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    Morfometria do trato vocal de indivíduos disfônicos com nódulos vocais em postura de repouso: um estudo com ressonância magnética
    (Universidade Federal de São Paulo (UNIFESP), 2009-02-18) Yamasaki, Rosiane Kimiko [UNIFESP]; Behlau, Mara [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To analyze the morphology of the vocal tract of individuals with vocal nodules compared with that of normal subjects by means of MNR imaging at high field in rest position. Methods: Twenty young adult women, 18 to 40 years old, 10 normal and 10 with vocal nodules diagnosis participated in the present research. All participants were tested for high-field MNR to achieve images in the median sagital and transverse sections. Eighteen measurements of the vocal tract: 15 in the median sagital section and three transversal were performed. Results: Of the measurements performed in the median sagital section, it was observed that the extent of the laryngeal vestibule area was statistically lower in the dysphonic group with vocal nodules, p = 0.012. The measure of the hard palate junction point with the soft palate (PJPDM) to the top of the hyoid bone tended to be lower in the group with nodes, p = 0.085. In the cross section, the distance between the right and left vocal processes of arytenoids’ cartilages, and the distance between the anterior commissure of the glottis to the lamina of the cricoid cartilage, were also significantly lower in the dysphonic group, with p values of 0.036 and 0.010, respectively. Conclusion: Based on these results, it is concluded that patients with vocal nodules show laryngeal vestibule constriction and reduction in the opening of the vocal folds in rest position. Although the sample is too small to allow any kind of generalization of the results, the findings show that, probably, patients with vocal nodules uphold laryngeal muscle tension even at rest. Additionally, provide evidences that the surgery, as a unique treatment of vocal nodules, may not be enough.
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    Perceptual Error Analysis of Human and Synthesized Voices
    (Mosby-Elsevier, 2017) Englert, Marina [UNIFESP]; Madazio, Glaucya; Gielow, Ingrid; Lucero, Jorge; Behlau, Mara [UNIFESP]
    Objective/ Hypothesis. To assess the quality of synthesized voices through listeners' skills in discriminating human and synthesized voices. Study Design. Prospective study. Methods. Eighteen human voices with different types and degrees of deviation (roughness, breathiness, and strain, with three degrees of deviation: mild, moderate, and severe) were selected by three voice specialists. Synthesized samples with the same deviations of human voices were produced by the VoiceSim system. The manipulated parameters were vocal frequency perturbation (roughness), additive noise (breathiness), increasing tension, subglottal pressure, and decreasing vocal folds separation (strain). Two hundred sixty-nine listeners were divided in three groups: voice specialist speech language pathologists (V-SLPs), general clinician SLPs (G-SLPs), and naive listeners (NLs). The SLP listeners also indicated the type and degree of deviation. Results. The listeners misclassified 39.3% of the voices, both synthesized (42.3%) and human (36.4%) samples (P = 0.001). V-SLPs presented the lowest error percentage considering the voice nature (34.6%)
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    Perda da voz em professores e não professores
    (Sociedade Brasileira de Fonoaudiologia, 2009-01-01) Park, Kelly [UNIFESP]; Behlau, Mara [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Centro de Estudos da Voz
    PURPOSE: To investigate teachers' and non-teachers' perception regarding the implications of an eventual loss of voice. METHODS: Participated in the study 205 individuals (106 women and 99 men), 105 teachers and 100 non-teachers, with ages varying from 23 to 65 years old. The participants were asked to answer a questionnaire with four questions regarding an eventual loss of vision, hearing, voice and deambulation, and the inferred impact degree (from 0 to 4). RESULTS: For the teachers group, not being able to see caused the most negative impact (mean of 3.8), followed by not being able to walk (mean of 3.7), loss of voice (mean of 3.7) and hearing loss (mean of 3.6). For the non-teachers group, loss of sight also caused the most negative impact (mean of 3.4), followed by not being able to walk (3.0), hearing loss (2.2), and loss of voice (2.0). Regarding the impact of an eventual voice loss, the teachers group indicated negative consequences at work, in their social relationships and in their daily routines. The non-teachers group indicated negative consequences to their daily routine, at work, in their social relationships and in their emotional manifestations. CONCLUSION: The teachers showed to value their voices differently from the non-teachers group. Both groups agreed that voice loss would not bring the most negative consequences. Although teachers noticed more the impact of an eventual loss of voice than non-teachers, the feelings towards this hypothetical situation were similar in both groups.
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    Perfil populacional de pacientes com disartria atendidos em hospital terciário
    (Sociedade Brasileira de Fonoaudiologia, 2009-01-01) Ribeiro, Ariella Fornachari; Ortiz, Karin Zazo [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To characterize the populational profile of dysarthric patients assisted in a tertiary hospital, and to present the most frequent speech disorders found in this population. METHODS: A specific protocol proposed for dysarthric patients was applied, gathering data through tasks that evaluate breathing, phonation, resonance, articulation, and prosody. Sixty protocols applied to patients evaluated at the Communication Disorders Ambulatory of the institution were the study took place were randomly selected for analysis. Data was descriptively analyzed. RESULTS: Regarding the populational profile of the dysarthric patients attended at a tertiary hospital, it was observed prevalence of male subjects, mostly aged from 20 to 50 years. The most common types of dysarthria were flaccid and unilateral upper motor neuron. Stroke was the most prevalent etiology for this speech disorder. Regarding the motor bases evaluated, it was observed a predominance of mixed breathing, hoarse voice, and normal velar movement, although mild hypernasality was identified. Articulation was mostly severely altered, and mild prosody alterations were predominant in the investigated population. CONCLUSION: It was possible to draw a profile of dysarthric patients assisted in a tertiary hospital in Brazil. The most common characteristics were: short breathing cycles, hoarse hypernasal phonation, moderate to severe articulation disorders, mild prosody impairment and low speech rate.
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    The Phonatory Deviation Diagram: A Novel Objective Measurement of Vocal Function
    (Karger, 2011-01-01) Madazio, Glaucya [UNIFESP]; Leao, Sylvia [UNIFESP]; Behlau, Mara [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Ctr Estudos Voz
    Aim: To identify the discriminative characteristics of the phonatory deviation diagram (PDD) in rough, breathy and tense voices. Methods: One hundred and ninety-six samples of normal and dysphonic voices from adults were submitted to perceptual auditory evaluation, focusing on the predominant vocal quality and the degree of deviation. Acoustic analysis was performed with the VoxMetria (CTS Informatica). Results: Significant differences were observed between the dysphonic and normal groups (p < 0.001), and also between the breathy and rough samples (p = 0.044) and the breathy and tense samples (p < 0.001). All normal voices were positioned in the inferior left quadrant, 45% of the rough voices in the inferior right quadrant, 52.6% of the breathy voices in the superior right quadrant and 54.3% of the tense voices in the inferior left quadrant of the PDD. in the inferior left quadrant, 93.8% of voices with no deviation were located and 72.7% of voices with mild deviation; voices with moderate deviation were distributed in the inferior and superior right quadrants, the latter ones containing the most deviant voices and 80% of voices with severe deviation. Conclusion: the PDD was able to discriminate normal from dysphonic voices, and the distribution was related to the type and degree of voice alteration. Copyright (C) 2011 S. Karger AG, Basel
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    Relação entre dados ocupacionais, sintomas e avaliação vocal de operadores de telesserviços
    (Sociedade Brasileira de Fonoaudiologia, 2011-03-01) Dassie-leite, Ana Paula; Lourenço, Luciana; Behlau, Mara [UNIFESP]; Universidade Estadual do Centro-Oeste Departamento de Fonoaudiologia; Micelli Soluções em Saúde Empresarial Departamento de Fonoaudiologia; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To relate data regarding gender, age and length of time on the job with voice symptoms and the results of vocal evaluation of teleservice operators. METHODS: A quantitative retrospective analysis was carried with 404 medical records regarding periodic evaluations of employees from bank institutions with owned headquarters contained in the files of a company of occupational medicine, 259 women, 145 men, with ages between 18 and 53 years (mean 30.48). The study had a descriptive exploratory design. RESULTS: Women presented greater quantity of voice symptoms (mean 1.69) and voice alterations (n=33; 12.7%) than men (mean 1.12; n=6; 4.1%). No difference was found between the amount of voice symptoms and the auditory-perceptive evaluation when related to age and length of time on the job. Employees with neutral voices (n=365; 90.35%) presented lesser symptoms (1.41) than employees with non-neutral voices (n=39; 9.65%; mean 2.21). Thirty-four (87.2%) of the 39 employees with non-neutral quality of voice presented laryngopharyngeal resonance, and 21 (53.8%) presented low pitch. Operators with moderate voice alteration presented increased loudness when compared to the operators with discreet alteration. CONCLUSION: Women present greater rate of voice symptoms and disorders. There is no relationship between the increase of age and length of time performing teleoperator functions with the increase of the number of symptoms and vocal alterations. Alterations of pitch, loudness and resonance are related to alterations on the quality of voice.
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    Acesso aberto (Open Access)
    Sinais e sintomas da disfunção autônoma em indivíduos disfônicos
    (Universidade Federal de São Paulo (UNIFESP), 2009-01-28) Park, Kelly [UNIFESP]; Behlau, Mara [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: The objective of this study is the occurrence of signs and symptoms of dysfunction of the autonomic nervous system in patients with behavioral dysphonia and compare the results with individuals without vocal complaints. Methods: A search of 128 adult subjects, categorized into 2 groups according to the presence of behavioral dysphonia (dysphonic group, 61 participants) and healthy voice (control group, 67 participants). The group with behavioral dysphonia was composed by 43 subjects were female and 18 male, aged between 14 and 66 years old, the healthy group with voice was composed of 45 women and 22 men, aged between 15 and 74 years. We applied the protocol of autonomic dysfunction (Demmink - Geertman & Dejonckere, 2002) containing 46 questions, distributed as follows: 22 related to the autonomic nervous system and no direct relationship with the voice, 16 related to both the autonomic nervous system and the voice, 6 points and 2 non-relevant questions of reliability. Results: There was a higher incidence of neurovegetative signs of changes in the group with behavioral dysphonia, especially in matters related to the voice (eight of 16 questions), and the higher occurrence of: frequent throat clearing (86.9%, N = 53, p <0001) , need to constantly swallowing (68.9%, N = 42, p <0001),fatigability when speaking (67.2%, N = 41, p <0001) and sore throat (65.6%, N = 40 , p <0011). As for symptoms neurovegetative without direct relationship with the voice, the individuals in the group with behavioral dysphonia had higher occurrence of three of the 22 symptoms: puffiness (85.2%, N = 52, p <0001), tinnitus (59%, N = 36, p = 0002) and aerophagia (57.4%, N = 35, p = 0003). Finally, on issues considered non-relevant, the groups behaved in a manner similar to them all. The consistency questions were excluded because of reliability problems in its formulation. Conclusion: individuals with behavioral dysphonia have a higher incidence of behavioral symptoms neurovegetative in general, particularly those who have direct relationship with the voice, indicating a greater lability of the autonomic nervous system.