A paralisia de prega vocal (PPV) decorre da lesão do nervo vago ou de seus ramos, podendo levar a alterações das funções que requerem o fechamento glótico. O tempo máximo de fonação (TMF) é um teste aplicado rotineiramente em pacientes disfônicospara avaliar a eficiência glótica e freqüentemente utilizado em casos de PPV, cujos valores encontram-se diminuídos. A classificação clínica clássica da posição da prega vocal paralisada em mediana, para-mediana, intermediária e em abdução ou cadavérica tem sido objeto de controvérsias. OBJETIVO: Verificar a associação e correlação entre os TMF e posição da prega vocal paralisada (PVP), TMF e ângulo de afastamento da PVP, medir o ângulo de afastamento da linha média das diferentes posições da PVP e correlacioná-lo com a sua classificação clínica FORMA DE ESTUDO: Clínico retrospectivo. MATERIAL E MÉTODO: Foram revisados os prontuários e analisados os exames videoendoscópicos de 86 indivíduos com paralisia de prega vocal unilateral e medido o ângulo de afastamento da PVP por meio de um programa computadorizado. RESULTADOS: A associação e correlação entre os TMF em cada posição assumida pela PVP têm significância estatística somente para /z/ na posição mediana. A associação e correlação entre TMF com ângulo de afastamento da PVP guardam relação para /i/, /u/. Ao associar e correlacionar medidas de ângulo com posição observa-se significância estatística em posição de abdução. CONCLUSÕES: Neste estudo não foi possível determinar as posições assumidas pela PVP por meio dos TMF nem correlacioná-las com medidas do ângulo.

Rev. Col. Bras. Cir. 2016; 43(3): INTRODUCTION Hyperparathyroidism is a condition in whichthere is an abnormal increase in the levels of parathyroid hormone (PTH), responsible for regulating the level of blood calcium and phosphate. The most common cause of hyperparathyroidism, seen in about 80% of cases, is the primary gland dysfunction due to an adenoma. Multiple adenomas or hyperplasia of the parathyroid glands are diagnosed in the remaining patients. Rarely the cause of hyperparathyroidism is a result of a parathyroid carcinoma. It is a disease for which therapy may be surgical, which involves the removal of the affected gland. When surgery is indicated in patients without prior treatment, the cure rate approaches 95% 1 . In cases where the initial operation is not successful, new surgical explorations become necessary, greatly increasing the number of complications and decreasing success rates to about 80% 2 . Therefore, regardless of the hyperparathyroidism origin, the surgeon who will treat these patients must indisputably have skill, experience and technical knowledge to obtain satisfactory results. Currently, advances in the identification of the glands through preoperatively performed diagnostic tests greatly facilitated parathyroid glands surgery. Frozen section biopsies 3 , intraoperative measurement of PTH levels 4 and less invasive procedures 5 allow great improvement in patients' quality of life 6 .However, the identification of the parathyroid glands, the recognition of their important role and the understanding of diseases that affect them traveled a long journey to the present state of knowledge. Since inception, the history of the parathyroid glands is full of incidental findings, often the case in medical history.The aim of this study is to provide the reader with a historical review of the discoveries fundamental to the understanding of the parathyroid glands and to discuss the current role and future prospects of surgery for the treatment of hyperparathyroidism. ANATOMY OF THE PARATHYROIDSThe parathyroid glands originate from the third and fourth pharyngeal pouches and are usually located 214-222 A B S T R A C TThe authors conducted a review of the major aspects of progression of knowledge about the surgical treatment of hyperparathyroidism.Through literature review, we analyzed articles on the history of the evolution of anatomical, physiological, pathological and surgical knowledge of the parathyroid glands. Because of their unique anatomical features, the parathyroid glands were the last of the endocrine glands to be discovered, which greatly hindered proper treatment until the first decades of the twentieth century. Technological developments in the last 30 years greatly facilitated the location of the glands and hyperparathyroidism surgery. However, an experienced and dedicated surgeon is still essential to the excellence of treatment.

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The paralyzed vocal fold positioning and the degree of dysphonia are important inputs when one is deciding upon treatment options for unilateral vocal fold paralysis (UVFP).Objective: To check voice characteristics and paralyzed vocal fold position in men with UVFP. Materials and Methods:This is a retrospective historical cross-sectional cohort study, with data from 24 men with UVFP with mean age of 60.7 years, submitted to voice assessment by three speech therapists and three ENT physicians used laryngeal images to classify the position of the paralyzed vocal fold. Results:The paralyzed vocal fold was found in the paramedian position in 45.83% of the cases; in the intermediary position in 25%; lateral in 20.83%, and it was in the median position in 4.16%; the dysphonia resulting from the UVFP was characterized by moderate hoarseness, roughness and stress in the voice; breathiness (most had severe breathiness); weakness and instability(mostly mild); the position of the paralyzed vocal fold had a significant influence on the general degree of vocal deviation. Conclusion:The general degree of dysphonia is associated with the paralyzed vocal fold position; dysphonia is characterized by hoarseness, breathiness, roughness and stress of moderate to severe levels. Braz J Otorhinolaryngol. 2011;77(6):761-7. ORIGINAL ARTICLE

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Objective To investigate the prevalence of antibodies against SARS-CoV-2 in otorhinolaryngologists in southern Brazil, its relationship to demographic data, professional practice and reported symptoms of COVID-19, and compare it with official data on other health-care workers of the state and the general population in the same period. Methods In this cross-sectional multicenter study, otolaryngologists actively practicing officially registered in Rio Grande do Sul were screened for IgM and IgG antibodies against SARS-CoV-2. A questionnaire was also applied. Results We screened 358 (80.1%) of 447 actively practicing otolaryngologists (195 [54.5%] male; mean [SD] age, 47.77 [13.57] years; range, 26–84 years). Twenty-three were positive for IgM and/or IgG (6.4%). This result was significantly associated with reports of infected household contacts (19/315 negatives and 8/23 positives; pp < 0.001). From 23 seropositive participants, 14 were asymptomatic (60.9%; pp < 0.001). There were no significant associations between seroconversion and age, sex, number of patient appointments and surgical procedures, workplace (hospital or private practice), patients with or without respiratory symptoms, or level of personal protective equipment used. The rate of COVID-19 in all health-care workers in the state was 7.69% at the end of the same period. Data from state government seroprevalence was 5.26 (risk ratio [RR]; 95% CI 3.27–8.45) and 4.66 (RR; 95% CI 2.93–7.43) times higher in otolaryngologists than in the general population in August and September, respectively. Conclusion sOtolaryngologists had a higher seroconversion rate than the general population. Using personal protective equipment, the level of occupational exposure did not result in higher rates of infection than other health-care workers, but the presence of infected household contacts was associated with higher rates of seroconversion.

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