RESUMOTema: características vocais acústicas da emissão em registro basal de pacientes adultos masculinos, portadores de fissura palatina pós-forame reparada cirurgicamente. Procedimentos: estudo de casos envolvendo quatro sujeitos do sexo masculino portadores de fissura palatina pós-forame reparada cirurgicamente. Foi realizada análise acústica da emissão sustentada da vogal [a] em registro modal e basal, através dos programas Multi Dimensional Voice Program (análise da fonte glótica) e Real-Time Spectrogram (análise espectrográfica), ambos da Kay Elemetrics Corp. Resultados: por meio da análise espectrográfica do basal, observou-se: diminuição de definição, intensidade e de largura de banda de alguns formantes, diminuição da intensidade de todo o espectro, e discreta diminuição do ruído nas altas frequências; o efeito damping apresentou discreto aumento. Pela análise da fonte glótica no basal através do MDVPA, observou-se: frequência fundamental dentro da faixa do registro modal de fala e aumentada quando comparada à emissão para comparação em registro modal; grande aumento das medidas que evidenciam variação de frequência e de amplitude; maioria das medidas de jitter e de shimmer significativamente aumentadas; medidas de ruído, de quebras de voz, de segmentos não sonorizados e de tremor aumentadas; e índice de fonação suave (SPI) significativamente diminuído. Conclusão: os resultados evidenciam a alta instabilidade e ruído da emissão em registro basal, bem como sua fraca intensidade e diminuição do fluxo aéreo transglótico. Conflito de interesses: inexistente consequentes, contudo, uma das alterações que mais chama a atenção em pacientes fissurados, por afetar a comunicação, é a hipernasalidade. Esta decorre do fechamento inadequado do esfínc-ter velofaríngeo (EVF), o que acaba por provocar a falta de isolamento entre as cavidades oral e nasal 3,4 , contaminando assim os sons orais por um foco de ressonância nasal 5 , além de dificultar que o indivíduo mantenha a pressão de ar na cavidade oral para a produção da fala 6 . A voz hipernasal pode transmitir a impressão de limitações físicas e intelectuais e até mesmo alterações emocionais ao indivíduo que a apresenta 5 . Uma das formas de tratamento da hipernasalidade é através de cirurgia corretiva 7,8 . Porém, muitas vezes, mesmo com a cirurgia reparadora, alguns fatores de ordem funcional conservam-se alterados. Para esses pacientes, a reabilitação fonoaudiológica, por meio da utilização de técnicas vocais é indicada 8 . DESCRITORES: INTRODUÇÃOA fissura lábio-palatina é uma malformação congênita 1,2 caracterizada por alteração na fusão dos processos faciais embrionários responsáveis pela formação da face, podendo acometer o lábio, o rebordo alveolar, o palato duro e o palato mole 3 . Os indivíduos portadores desse tipo de malformação podem apresentar diversos acometimentos
Patients with palatine fissure have inadequate velopharyngeal closure (VPC), with consequent vocal hypernasality which can be reduced by a basal tone. Aim: to compare VPC during a basal tone with the emission of a modal recording, in patients with repaired post-foramen palatine fissure. Materials and methods: case study with four adult men, all with repaired post-foramen palatine fissure. VPC images through nasal-pharyngoscopy during the emission o f the [a] vowel in a modal and basal recording. The images were studied by four ENTs. Results: in three subjects there was no change in the type of VPC considering the recordings analyzed; the changes which happened to most of the subjects are associated only to the degree of movement of the structures involved, since in the basal recording the movement of the laryngeal lateral walls was kept, the movement of the posterior pharyngeal wall stabilized, the movement of the palatine veil was mildly reduced, and the Passavant fold was evident. Conclusions: The type of VPC was kept in the four subjects analyzed, when we compared the modal and basal recordings, there was a modification in the degree of movements in the structures involved, making it clear the Passavant Fold.
BSTRACTThe work of speech-language pathologists uses exercises such as the vocal fry (VF), which originates from the great contractile activity of the intrinsic laryngeal thyroarytenoid muscle (TA). The aim of this study was to review the literature related to TA and VF.A literature review of the last 20 years on the subject was performed in the databases LILACS, SciELO, PubMed, Web of Science and Google Scholar. It was found that the internal beam of the TA has slow twitch fibers, isotonic, resistant to fatigue; the external beam provides fast twitch, fatigable and isometric fibers. The VF is characterized by the perception of the vibration of the glottal pulses during the emission of the lowest frequencies in the vocal range (crackling in bass or vocal fry), mainly by the action of the TA, especially its inner portion, which shows evident shortening, dropping the mucosa in great volume along the free edge, increasing subglottic pressure and jitter, shimmer and noise levels, and reducing the airflow. Based on the literature, the isometric exercise with the external TA happens with VF sustained in the lowest possible frequency to the subject (maximum contraction), for six seconds, five to ten times daily, consistent with its predominance of fast twitch fibers. In the isotonic exercise with the internal TA, high sounds must be to stretch the muscle, alternating emissions by VF (concentric contraction) and in modal register and falsetto head (high-pitched sounds) (eccentric contraction) with several daily series of eight to 12 repetitions, consistent with the predominance of slow twitch fibers.
Introduction It is known that the basal sound promotes shortening and adduction of the vocal folds and leaves the mucosa looser. However there are few studies that address the supralaryngeal physiological findings obtained using the technique. Objective To check the effectiveness of using vocal fry on the voice and velopharingeal port closure of five adult subjects, whose cleft palate has been corrected with surgery. Methods Case study with five subjects who underwent otolaryngology examination by means of nasopharyngoscopy for imaging and measurement of the region of velopharyngeal port closure before and after using the vocal fry technique for three minutes. During the exam, the subjects sustained the isolated vowel /a:/ in their usual pitch and loudness. The emission of the vowel /a:/ was also used for perceptual analysis and spectrographic evaluation of their voices. Results Four subjects had an improvement in the region of velopharyngeal port closure; the results of the spectrographic evaluation were indicative of decreased hypernasality, and the results of the auditory-perceptual analysis suggested improved overall vocal quality, adequacy of loudness, decreased hypernasality, improvement of type of voice and decreased hoarseness. Conclusion This study showed a positive effect of vocal fry on voice and greater velopharyngeal port closure.
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