Os grandes avanços na compreensão da fisiologia vocal e o desenvolvimento científico e tecnológico na área de voz permitiram transpor o limite terapêutico através dos meios para a detecção precoce de alterações vocais. Objetivo: Avaliar indivíduos sem queixa vocal e correlacionar possíveis achados telelaringo-estroboscópicos, perceptivo-auditivos e acústicos. Forma de Estudo: Observacional coorte com corte transversal. Casuística e Méto-do: Foram avaliados 21 indivíduos do sexo masculino, com idade variando de 20 a 50 e mediana de 33 anos, sem queixas vocais, que não faziam uso de tabaco nem de destilados. Os sujeitos foram submetidos às avaliações telelaringo-estroboscópica, perceptivoauditiva e acústica da voz. Resultados: Do total de sujeitos avaliados, 57,15% apresentaram alteração em uma ou mais das avaliações realizadas. À telelaringo-estroboscopia, observou-se fenda vocal triangular posterior em 4 sujeitos. Dez apresentaram alteração na análise perceptivo-auditiva, observando-se os seguintes parâmetros: instabilidade, rouquidão e soprosidade, todos em grau discreto. Na avaliação da ressonância, três apresentaram cada foco hipernasal, cul de sac e laringo-faríngea. A avaliação acústica apresentou as seguintes médias: f0 -125,69 Hz; jitter -0,22%; shimmer -3,06%; NNE -12,29 dB; HNR -20,75 dB; freqüência do tremor -2,09 Hz; amplitude do tremor -1,16 Hz. Alguns sujeitos apresentaram valores de shimmer% e freqüência do tremor maiores do que a média. Conclusão: Foram detectadas alterações em 57,15% das avaliações realizadas em indivíduos sem queixas vocais. Esses achados podem ser indicativos de uma variação da normalidade ou representar uma predisposição a alterações glóticas e vocais que, com o passar do tempo, podem desenvolver-se. Em todas as avaliações alteradas houve alteração de parâmetro acústico. The great progress in understanding the vocal physiology and the scientific and technological development in the voice area allow transposing the therapeutic limit through the means for the precocious detection of vocal changes. Objective: to evaluate subjects without vocal complaint, and to correlate possible videostroboscopic, perceptual and acoustic analysis finding. Study Design: Observacional cohort with transversal cut. Patients and Methods: 21 men without vocal complaints were studied. Their ages ranged from 20 to 50 with median of 33. They were neither alcohol nor smoke users. The subjects underwent the videostroboscopic, perceptual and acoustic evaluations. Results: 57.15% of the subjects presented any alteration in one or more of the evaluated aspects. In the videostroboscopy it was observed posterior triangular gap in 4 subjects. Ten subjects presented a mild grade alteration in the perceptual analysis, in instability, hoarseness and breathiness parameters. Three subjects presented respectively hipernasal, cul de sac and pharyngolaryngeal resonance focus. The acoustic evaluation presented the following averages: f0 -125.69 Hz; jitter -0.22%; shimmer -3.06%; NNE --12.29 dB; HNR -20.75 dB; tremor freq...

The purpose of this study was to investigate variations in the voice by three experienced speech-language therapists. Forty-eight men and nine women from the Associação dos Alcoólicos Anônimos, Santos were studied. Their ages were from 28 to 81 years, with median of 49 years and everyone was a smoker for 60 to 720 months. Most of them used more than 20 cigarettes a day and all of them had stopped alcohol use for 1 to 25 months. The perceptual analysis of the voices was performed by means of the GRBAS scale. The voice sample consisted of a sustained vowel /a/ at a comfortable pitch and loudness level. The three judges were blinded to the opinion of their colleagues and a kappa test was applied. For roughness, the concordance rates were 59.6% for observers 1 and 2 (kappa = 0.234); 47.4% for 1 and 3 (kappa = 0.047) and 52.6% (kappa = 0.016) for 2 and 3. For breathiness, the concordance rates were 80.7% for observers 1 and 2 (kappa = 0.191); 57.9% for 1 and 3 (kappa = 0.147) and 57.9% (kappa = 0.156) for 2 and 3. With regard to asthenic quality, there was concordance of 100% for observers 1 and 2, so kappa could not be applied; the concordance rate was 96.5% for 1 and 3 and for 2 and 3. The evaluation for strained voice revealed concordance rates of 71.9% for observers 1 and 2 (kappa = -0.017); 59.6% for 1 and 3 (kappa = 0.095) and 70.2% (kappa = 0.039) for 2 and 3. The disagreement among the observers was worst for pathological rather than normal voices; when disagreement was present among experienced judges, it was of only one point in the scale used.

Objectives: The objective of this study was to evaluate the conventional laryngoscopy, laryngostroboscopy, perceptual and acoustic evaluation of 28 male chronic smokers. Methods: Volunteer sample of 28 male smokers whose ages averaged 53 years. Smoking habit varied from 96 to 720 months. Standard transoral rigid videolaryngoscopy with stroboscopy was performed. The examinations were recorded on videotape (video home system format). The recorded material was analyzed by a physician according to Hirano & Bless protocol (1993). A grading system described by Yonekawa (1983) was used in order to assess the severity of the Reinke edema (RE). The subjective judgment of the voice quality was carried out by 5 experienced speech-language pathologists. The GRBAS system was used to describe the voice quality. For the acoustic assessment, the following factors were analyzed: fundamental frequency; jitter; shimmer; NNE; and HNR. Results: The conventional laryngoscopy was able to identify RE in 9 patients. In the laryngostroboscopy, RE was identified in 16 examinations with prevalence of type II. Besides it, 1 polyp, 1 leucoplakia; 1 bilateral angiodisgenesia and 1 vocal fold scar were described. The perceptual evaluation presented revealed prevalence of strainless and roughness. The acoustic analysis demonstrated higher rates of fundamental frequency, shimmer, and HNR. The jitter rates were lower than the normal. Conclusion: A rate of 57% of chronicle male smokers presented RE with no significant vocal repercussion. The perceptual evaluation showed alterations in larger scale related to the vocal tract ressonance and all the acoustic rates alterated.

the age of 12. After that, the threshold moved to the stable. The audiogram indicated an asymmetric pattern and sensorineural hearing loss predominantly. A caloric test revealed a normal response on both sides. Corticosteroids were not effective in improving hearing loss. A diffuse goiter was noticed at the age of 15 years. The goiter slightly enlarged over the 12 years follow-up period.Conclusion: Although the His723Arg missense mutation is a change at unconserved position in the pendrin protein, it is a pathological mutation in our case because it was found in the homozygous state. It is possible that different mutations within the same gene lead to different phenotypes.