Summary Introduction Since the beginning of the new pandemic, COVID-19 health services have had to face a new scenario. Voice therapy faces a double challenge, interventions using telepractice, and delivering rehabilitation services to a growing population of patients at risk of functional impairment related to the COVID-19 disease. Moreover, as COVID-19 is transmitted through droplets, it is critical to understand how to mitigate these risks during assessment and treatment. Objective To promote safety, and effective clinical practice to voice assessment and rehabilitation in the pandemic COVID-19 context for speech-language pathologists. Methods A group of 11 experts in voice and swallowing disorders from five different countries conducted a consensus recommendation following the American Academy of Otolaryngology-Head and Neck Surgery rules building a clinical guide for speech-language pathologists during this pandemic context. Results The clinical guide provides 65 recommendations for clinicians in the management of voice disorders during the pandemic and includes advice from assessment, direct treatment, telepractice, and teamwork. The consensus was reached 95% for all topics. Conclusion This guideline should be taken only as recommendation; each clinician must attempt to mitigate the risk of infection and achieve the best therapeutic results taking into account the patient's particular reality.

The motility of the pharynx, upper esophageal sphincter (UES), and proximal esophagus in patients with oropharyngeal dysphagia is still not entirely understood. High-resolution manometry (HRM) was recently added to the armamentarium for the study of this area. This study aims to describe HRM findings in patients with vagal paralysis. Sixteen patients (mean age 54 years, 69% females) with oropharyngeal dysphagia due to unilateral vagal paralysis were prospectively studied. All patients underwent HRM. Motility of the UES and at the topography of the velopharynx and epiglottis were recorded. (1) UES relaxation is compromised in a minority of patients, (2) epiglottis pressure does not follow a specific pattern, (3) vellum is hypotonic in half of the patients, (4) dysphagia is related to a low pharyngeal pressure, not to a flow obstruction at the level of the UES, and (5) aspiration is related to low pressures at the level of the UES and epiglottis and higher pressures at the level of the vellum. Pharyngeal motility is significantly impaired in patients with oropharyngeal dysphagia and unilateral vagal paralysis. In half of the cases, UES resting pressure is preserved due to unilateral innervation and relaxation is normal in most patients. Dysphagia therapy in these patients must be directed toward improvement in the oropharyngeal motility not at the UES.

Purpose: To identify and characterize the presence of body pain related to voice usage in choral singers. Methods:A questionnaire investigating the occurrence of voice problems, vocal self-evaluation, and a report of body aches was given to 50 classical choral singers and 150 participants who were non-singers. Thirteen types of aches were investigated that were distributed into two groups: larynx proximal ache (temporomandibular joint, tongue, sore throat, neck, back of the neck, shoulder, and pain while speaking) and distal ache (headache, backache, chest, arms, hands, and ear ache). Results: Classical choral singers had less presence of pain than the general population. The most related pain types reported in singers were sore throat, chest, and shoulder, respectively. Conclusion: Reduced vocal signs of pain in singers may suggest that singers can benefit from vocal training once they have better voice usage due to voice practice, offering a protective effect to the development of voice disorders since voice training builds up a better musculoskeletal endurance. RESUMOObjetivo: Identificar e caracterizar dores corporais em coristas eruditos. Métodos: Foi aplicado um questionário autoexplicativo a 50 coristas eruditos e 150 sujeitos da população geral, com questões de caracterização pessoal e sobre a presença e frequência de 13 tipos de dores corporais: cabeça, pescoço, nuca, ombros, costas, peito, mão, ouvido, língua, articulação temporomandibular, garganta e dor ao falar. Resultados: Coristas eruditos relataram menos dores do que a população geral. Os tipos de dores mais relatados por coristas foram garganta, costas e ombros, respectivamente. Conclusão: A baixa ocorrência de dores corporais em coristas eruditos sugere que o uso vocal saudável, aliado ao treino da musculatura respiratória e de produção vocal, pode oferecer uma maior resistência musculoesquelética, prevenindo o aparecimento de doenças associadas a ela.

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The purpose of the study is to explore two reduced versions of the PEED-27 (Brazilian VDCQ) and compare them to the original version. It was performed a retrospective analysis of PEED-27 questionnaires of 100 individuals with vocal disorder, 37 men and 63 women, mean age of 43.7 in order to compare reduced versions of the instrument. The analysis showed that the three instruments have high level of correlation, thus their results are comparable (PEED 27 x 15, r=+0.910, p< 0.001; PEED 27 x 10, r=+0.873, p<0.001 and PEED 15 x 10, r=+0.924, p< 0.001). The PEED-10 and PEED-15 are reduced and adapted versions to the Brazilian Portuguese language. They evaluate strategies used by dysphonic individuals to cope with their voice problem. The clinician must decide which version to use based on the available time and on the need of more detailed information.

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Introduction. Since the beginning of the new pandemic, COVID-19 health services have had to face a new scenario. Voice therapy faces a double challenge, interventions using telepractice, and delivering rehabilitation services to a growing population of patients at risk of functional impairment related to the COVID-19 disease. Moreover, as COVID-19 is transmitted through droplets, it is critical to understand how to mitigate these risks during assessment and treatment. Objective. To promote safety, and effective clinical practice to voice assessment and rehabilitation in the pandemic COVID-19 context for speech-language pathologists. Methods. A group of 11 experts in voice and swallowing disorders from 5 different countries conducted a consensus recommendation following the American Academy of Otolaryngology-Head and Neck Surgery rules building a clinical guide for speech-language pathologists during this pandemic context. Results. The clinical guide provides 79 recommendations for clinicians in the management of voice disorders during the pandemic and includes advice from assessment, direct treatment, telepractice, and teamwork. The consensus was reached 95% for all topics. Conclusion. This guideline should be taken only as recommendations; each clinician must attempt to mitigate the risk of infection and achieve the best therapeutic results taking into account the patient's particular reality.

RESUMO Objetivo Desenvolver um game sobre saúde e higiene vocal (VoxPedia) e aplicá-lo em adultos, para investigar o conhecimento em cuidados vocais e compreender a autoavaliação vocal dos respondentes. Método Participaram 293 adultos, 204 mulheres e 129 profissionais da voz, convidados através de mídias digitais. Os participantes responderam: 1) Termo de Consentimento Livre e Esclarecido (TCLE); 2) Dados de Identificação; 3) Protocolo do Índice de Desvantagem Vocal (IDV-10); 4) Questionário de Saúde e Higiene Vocal (QSHV); 5) Aplicação do quiz VoxPedia. Resultados O VoxPedia foi desenvolvido com questões simples e com dinâmica que permitiu aos participantes conhecerem seu desempenho em tempo real. Os dados adquiridos através do quiz mostram que os profissionais da voz relataram menos desvantagem vocal e acertaram mais itens no QSHV e questões do VoxPedia. Profissionais da voz ou não, os participantes que erraram a natureza do impacto dos aspectos de saúde no QSHV referiram maior desvantagem vocal no IDV-10. Contudo, apesar da desvantagem autorreferida, a maioria não relata problemas de voz. Em contrapartida, quando o respondente relatou problemas de voz, nem sempre houve desvantagem percebida ou busca por terapia vocal. Conclusão O VoxPedia apresentou alguns conceitos de saúde e higiene vocal aos participantes. Além disso, possibilitou o estudo das relações entre conhecimento em cuidados vocais e autoavaliação vocal. Os dados sugerem que os indivíduos com mais conhecimento em cuidados vocais têm melhor autoavaliação de voz; participantes com pior autoavaliação vocal não percebem problemas de voz; e aqueles que percebem problemas vocais não necessariamente procuram cuidados profissionais.