Efeito da técnica de empuxo com cabeça lateralizada nos parâmetros da videoquimografia em adultos jovens vocalmente saudáveis
Data
2023-11-16
Autores
Melo, Fabrício Vieira de 
Orientadores
Odagima, Rosiane Kimiko Yamasaki
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: Conhecer o efeito das técnicas vocais na morfofisiologia laríngea é importante para o tratamento efetivo dos pacientes com distúrbios vocais, uma vez que auxilia na tomada de decisão quanto às estratégias terapêuticas a serem selecionadas. A técnica de esforço, também conhecida como técnica de empuxo, tem importante indicação clínica nos casos de paralisia de prega vocal, podendo ser realizada com cabeça retificada ou com cabeça virada para o lado. No entanto, ainda faltam estudos que mostram os efeitos da técnica de empuxo com cabeça lateralizada nas características de vibração das pregas vocais, mesmo em pessoas vocalmente saudáveis. Objetivo: Verificar o efeito da técnica de empuxo com mãos em gancho e cabeça lateralizada para a esquerda nos parâmetros da videoquimografia, obtidos da videoendoscopia de alta velocidade (High Speed Imaging), em indivíduos jovens vocalmente saudáveis. Método: Participaram da pesquisa 11 indivíduos sem queixa vocal e sem alteração laringológica, faixa etária de 20 a 35 anos, 6 do sexo masculino e 5 do sexo feminino. Todos foram submetidos ao exame de videolaringoscopia de alta velocidade. O laringoscópio é introduzido pela cavidade oral. A tarefa de fala será a vogal sustentada /e/. O exame é realizado durante a emissão da vogal com cabeça virada para a esquerda, sem mãos em gancho (sem esforço) e, posteriormente, com mãos em gancho (com esforço). Dessa forma, serão realizadas duas aquisições de imagens de cada participante. A análise das características de vibração das pregas vocais será realizada com base nas imagens de videoquimografia de alta velocidade. Serão selecionados 7 ciclos glóticos consecutivos. Para tanto, é utilizada a linguagem de programação C Sharp, que extrai, em milissegundos, os parâmetros da fase fechada (TC), da fase aberta (TO), da fase de fechamento (Tc) e da fase de abertura (To) dos ciclos glóticos. Além desses parâmetros, é analisado também a Razão de Abertura (RA), que mede a amplitude da prega vocal direita em relação à prega vocal esquerda durante o ciclo glótico. Variável independente: técnica de empuxo com cabeça lateralizada para a esquerda. Variáveis dependentes: parâmetros da videoquimografia. Resultados: A técnica de empuxo com cabeça lateralizada para a esquerda gerou aumento da fase fechada (TC) de efeito pequeno e f0 menor de efeito grande no gênero feminino. Independente do gênero, a prega vocal direita apresentou resultados importantes como: Aumento no quociente de velocidade (SQ) de efeito moderado e diminuição do tempo da fase de abertura (To) de efeito pequeno, e a razão entre as pregas foi menor com a utilização da técnica. Conclusão: A técnica de empuxo com cabeça lateralizada para a esquerda realizou efeitos diretos nos parâmetros da videoquimografia destacando-se o comportamento da prega vocal direita quanto à velocidade da fase de abertura (To), com resultados mais evidentes no gênero feminino.
Introduction: Knowing the effect of vocal techniques on laryngeal morphophysiology is important for the effective treatment of patients with vocal disorders, as it helps in decision-making regarding the therapeutic strategies to be selected. The effort technique, also known as the pushing technique, has an important clinical indication in cases of vocal fold paralysis and can be performed with the head straightened or with the head turned to the side. However, there is still a lack of studies showing the effects of the lateralized head thrust technique on the vibration characteristics of the vocal folds, even in vocally healthy people. Objective: To verify the effect of the thrust technique with hooked hands and head lateralized to the left on videokymography parameters, obtained from high-speed videoendoscopy (High Speed Imaging), in young, vocally healthy individuals. Method: 11 individuals without vocal complaints and laryngological disorders participated in the research, aged between 20 and 35 years, 6 males and 5 females. All underwent high-speed videolaryngoscopy examination. The laryngoscope is introduced into the oral cavity. The speaking task will be the sustained vowel /e/. The exam is performed during the emission of the vowel with the head turned to the left, without hooked hands (without effort) and, later, with hooked hands (with effort). Therefore, two image acquisitions will be carried out for each participant. The analysis of the vibration characteristics of the vocal folds will be carried out based on high-speed videokymography images. 7 consecutive glottal cycles will be selected. To this end, the C Sharp programming language is used, which extracts, in milliseconds, the parameters of the closed phase (TC), the open phase (TO), the closing phase (Tc) and the opening phase (To) of the glottal cycles. In addition to these parameters, the Opening Ratio (RA) is also analyzed, which measures the amplitude of the right vocal fold in relation to the left vocal fold during the glottal cycle. Independent variable: thrust technique with head lateralized to the left. Dependent variables: videokymography parameters. Method of analyzing the results: The average values of the parameters of high-speed videokymography with the head lateralized to the left, without and with the effort technique, in this case, with hooked hands, will be obtained. Results: The pushing technique with head lateralized to the left generated an increase in the closed phase (TC) with a small effect and a smaller f0 with a large effect in females. Regardless of gender, the right vocal fold presented important results such as: Increase in the speed quotient (SQ) with a moderate effect and a decrease in the opening phase time (To) with a small effect, and the ratio between the folds was smaller with the use of the technique. Conclusion: The pushing technique with the head lateralized to the left had direct effects on the videokymography parameters, highlighting the behavior of the right vocal fold in terms of the speed of the opening phase (To), with more evident results in females.
Introduction: Knowing the effect of vocal techniques on laryngeal morphophysiology is important for the effective treatment of patients with vocal disorders, as it helps in decision-making regarding the therapeutic strategies to be selected. The effort technique, also known as the pushing technique, has an important clinical indication in cases of vocal fold paralysis and can be performed with the head straightened or with the head turned to the side. However, there is still a lack of studies showing the effects of the lateralized head thrust technique on the vibration characteristics of the vocal folds, even in vocally healthy people. Objective: To verify the effect of the thrust technique with hooked hands and head lateralized to the left on videokymography parameters, obtained from high-speed videoendoscopy (High Speed Imaging), in young, vocally healthy individuals. Method: 11 individuals without vocal complaints and laryngological disorders participated in the research, aged between 20 and 35 years, 6 males and 5 females. All underwent high-speed videolaryngoscopy examination. The laryngoscope is introduced into the oral cavity. The speaking task will be the sustained vowel /e/. The exam is performed during the emission of the vowel with the head turned to the left, without hooked hands (without effort) and, later, with hooked hands (with effort). Therefore, two image acquisitions will be carried out for each participant. The analysis of the vibration characteristics of the vocal folds will be carried out based on high-speed videokymography images. 7 consecutive glottal cycles will be selected. To this end, the C Sharp programming language is used, which extracts, in milliseconds, the parameters of the closed phase (TC), the open phase (TO), the closing phase (Tc) and the opening phase (To) of the glottal cycles. In addition to these parameters, the Opening Ratio (RA) is also analyzed, which measures the amplitude of the right vocal fold in relation to the left vocal fold during the glottal cycle. Independent variable: thrust technique with head lateralized to the left. Dependent variables: videokymography parameters. Method of analyzing the results: The average values of the parameters of high-speed videokymography with the head lateralized to the left, without and with the effort technique, in this case, with hooked hands, will be obtained. Results: The pushing technique with head lateralized to the left generated an increase in the closed phase (TC) with a small effect and a smaller f0 with a large effect in females. Regardless of gender, the right vocal fold presented important results such as: Increase in the speed quotient (SQ) with a moderate effect and a decrease in the opening phase time (To) with a small effect, and the ratio between the folds was smaller with the use of the technique. Conclusion: The pushing technique with the head lateralized to the left had direct effects on the videokymography parameters, highlighting the behavior of the right vocal fold in terms of the speed of the opening phase (To), with more evident results in females.