A disfonia tem recebido um enfoque ocupacional crescente e torna-se necessário, ao otorrinolaringologista, atualizar a abordagem clínica dos trabalhadores que usam a voz como instrumento de trabalho, onde novas catagorias profissionais têm surgido e, com elas, as disfunções vocais conseqüentes às condições de trabalho. Hoje, há grandes preocupações com o prejuízo econômico e produtivo que o ditúrbio vocal possa gerar. Sabe-se que a disfunção vocal tem como característica a multicausalidade e, por isso, a avaliação, conclusão e emissão de relatórios médicos tornam-se incertos. Objetivo: Para melhor avaliar estes profissionais e garantir um atendimento com respaldo científico adequado, estabeleceu-se um protocolo multidisciplinar, que consiste em anamnese dirigida, exame físico, endoscopia laríngea, análise perceptiva da voz e aplicação do Voice Handicap Index (VHI). Forma de estudo: Coorte histó-rica transversal. Material e método: Para testar o uso do méto-do, em caráter preliminar, o protocolo foi aplicado em 15 profissionais que usavam a voz para trabalhar. Então, realizou-se um estudo retrospectivo com estes pacientes. Resultado: Demonstrou-se que 13,3% dos profissionais apresentaram performance vocal normal; 33,3%, disfonia funcional e 46%, disfonia orgânico-funcional. A disfunção vocal foi relacionada ao exercício do trabalho em 40% dos pacientes e em 46,6% ela foi descartada. Conclusão: Concluiu-se que o método é suficientemente abrangente e pode ser de utilidade ao otorrinolaringologista, para a avaliação clínico-ocupacional deste grupo de pacientes. Dysphoni a has an occupational view nowadays. A shift in the voice-oriented professional's clinical approach has been required. New voice-oriented job categories have emerged and, as a result, the voice disorder in the professional enviroment has increased. The economic and productivity harm due to voice disorders are a preocupation. Dysphonia has multiple causes and its evaluation, ethiological conclusion and occupational reports aren't defined yet. Aim: In order to obtain a more accurate and comprehensive evaluation, a multidisciplinary protocol was elaborated to ensure proper medical scientific support. It consists of anamnesis, physical exam, laryngeal endoscopy, perceptive voice analysis and Voice Handicap Index application (VHI). Study design: Transversal historic cohort. Material e método: In this preliminary study, the protocol was applied on 15 voice professionals with dysphonia. Results: 13,3% with normal voice performance; 33,3% with functional dysphonia; 46% with organic dysphonia. Dysphonia was related to the voice-oriented job in 40% cases and it was ruled out in 46,6%. Conclusion: We concluded that the protocol is complete enough to help otolaryngologists evaluate this workers' category. EricaPalavras-chave: disfonia, ocupacional, multidisciplinar.

there was a higher frequency of rhinosinusitis in HSCT and GVHD. The type of transplant does not appear to predispose to the occurrence of rhinosinusitis. GVHD seems to be an aggravating factor and requires a more stringent treatment.

Methods of deli vering and monitorin g anesthesia durin g microlaryngeal surge ry are constantly evolving. In 1994, Hunsaker and colleagues introduced a laser-safe subglottic Mon-Jet ventilation tube. which has the abili ty to periodically measur e end-tidal carbon dioxid e levels. We conducted a retrospective review of 84 consecutive patients who had undergon e microla ryngeal p rocedures with the aid of the Hunsaker Mon-Jet tube. Study parameters included the length of anesthetic induction and recovery times, the durati on of surgery, the degree of surgical access to the laryn x, and the incidence of anesthetic and surgical complications. We fo und that anesthetic induction and recovery times with the use of the Mon-Jet tube were comparable to those seen with standard endotracheal intubation. We also observed an apparent reduction in surgical time and a consistent subjective improvement in surgical visualization and access. The complication rate was acceptable, airway cont rol was adequat e, and use ofthe Mon-Jet tube was safe in all pati ents. We conclude that the Mon-Jet tube is a safe and effe ctive subglottic j et ventilation system and that it has distinct advantages over other methods f or both the surgeon and the anesthesiologist.

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RS frequency was 49%; GVHD is a predisposing condition to RS; sinusectomy may be necessary to control RS in GVHD patients.